When confronted by evidence that the TST may/is less than perfect the
Australian Tuberculosis Review resort to their default position;
The major limitation is that we don't have a gold standard
The lack of a gold standard does not diminish the science. QuantiFERON uses antigens that are specific only to Tuberculosis and therefore must be more accurate than the TST, which uses a broad range of antigens not specific to Tuberculosis. The lack of a gold standard has not stopped other doctors appreciating the science and acting accordingly eg
San Jose
..The Student Health Center will no longer be offering PPD skin tests.
..The Quantiferon Gold test is more accurate than the PPD
