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SIR—Bellete et al. [1] and the accompanying editorial by Nadal [2] report on the whole blood interferon-γ release assay (IGRA; QuantiFERON-TB; Cellestis) and its performance relative to the tuberculin skin test (TST), but they appear selective in using methods and data that favor the TST. Although Nadal [2] refers in passing to problems with the TST, both articles consider differences between the IGRA and the TST as a negative factor, tacitly accepting that the TST is the gold standard and overlooking facts to the contrary. We suggest their conclusions are unsound and biased in favor of the TST; as developers of the IGRA that they used, we admit to having a commercial bias, but at least you know where we stand.

Selectivity is inherent in the article by Bellete et al. [1], as it includes data from a small subset (<15%) of subjects in a multicenter trial already reported by Mazurek et al. [3]. Nadal's editorial [2] infers that we accept the conclusions drawn from the data for the 175-subject Baltimore subset, not those from the data for the total group of 1234 subjects studied by Mazurek et al. [3]—a statistical absurdity. Although we take issue with many aspects of the article by Bellete et al. [1], mostly because of its overinterpretation of a small and biased sample, it is the uncritical acceptance of the TST in Nadal [2] that we consider to fall short of reviewing standards.

Issue Section:
Correspondence
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