“Utility of Cerebrospinal Fluid Unstimulated Interferon-Gamma (IRISA-TB) as a Same-Day Test for Tuberculous Meningitis in a Tuberculosis-Endemic, Resource-Poor Setting”

To the Editor—We read with great interest the recently published article by Randall et al titled “Utility of Cerebrospinal Fluid Unstimulated Interferon-Gamma (IRISA-TB) as a Same-Day Test for Tuberculous Meningitis in a Tuberculosis-Endemic, Resource-Poor Setting.” We applaud the investigators for their efforts to evaluate same-day host-based diagnostics for tuberculous meningitis (TBM) and agree that improved TBM diagnostic testing remains a priority and would likely improve mortality in this vulnerable population. However, we would like to highlight that in diagnostic accuracy studies that lack a perfect gold standard reference test, as is the case with TBM, consistency among studies is important.