Evaluating the Latent Tuberculosis Diagnostic Tests Using Fuzzy PROMETHEE: A Multi-Criteria Decision Approach

BACKGROUND/AIMS: Latent tuberculosis infection (LTBI) remains a critical challenge in global tuberculosis (TB) control efforts, necessitating effective diagnostic techniques.This study provides a comprehensive analysis of 7 diagnostic methods for LTBI, including QuantiFERON-TB and T-SPOT.TB. MATERIALS AND METHODS:Seven different diagnostic techniques were evaluated against criteria such as specificity to Mycobacterium tuberculosis, sensitivity, cost-effectiveness, accessibility, limitations, turnaround time, etc. using multi-criteria decision-making methods (MCDMs).Weightings for each criterion were applied to account for their relative importance in clinical decision-making.To validate the results obtained using the fuzzy preference ranking organization method for enrichment evaluations we applied two additional MCDMs: the weighted sum method and the technique for order of preference by similarity to ideal solution using the same criteria, alternatives, and weightings.RESULTS: Indicate that QuantiFERON-TB with a NetFlow of 0.0577 ranks highest in overall performance.T-SPOT.TB and Diaskintest followed closely, with minor variations in their rankings between the methods, while traditional methods such as Tuberculin Skin tests ranked lower due to their limitations in specificity and cross-reactivity.Sensitivity analysis further validated these rankings, suggesting that modern blood-based assays offer superior diagnostic accuracy and operational efficiency. CONCLUSION:This study highlights the potential of fuzzy-based MCDM for selecting diagnostic tools for LTBI, contributing to more informed clinical practices and effective TB control strategies.