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Understanding the TB Cohort Review Process: Instruction Guide
2006
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What Is the Cohort Review Method?
3. Timeline for Activities in the Cohort Review Process
A “cohort” is a group of TB patients who are being managed over
a specific period of time, usually 3 months. In order to evaluate
treatment and contact investigation outcomes, the patients’ cases
are reviewed approximately 6–9 months after initial case reporting.
This is after most patients with TB disease have had time
to complete treatment and after most contacts have been identified,
evaluated, and started on treatment for latent TB infection (LTBI),
if indicated. A review at 6–9 months allows the TB control
team to evaluate the adequacy of treatment and correct any problem
areas while there is still time for the patient to complete treatment
within 365 days. Most contacts infected with LTBI will not
have completed therapy because of the time gap between patient reporting,
testing of contacts, and the 9-month duration of standard isoniazid
(INH) treatment. Contacts on treatment for LTBI should be
tracked through to completion by the case manager. The data
analyst reports treatment completion rate for contacts at the next
review session.
The following timeline illustrates the cohort review process:
Table 8: Cohort Review Timeline
1ST Quarter Months 1–3 |
2ND Quarter Months 4–6 |
3RD Quarter Months 7–9 |
4TH Quarter Months 10–12 |
Next Year 1ST Quarter Months 1–3 |
TB cases counted Treatment started
Contact investigation initiated |
Ongoing treatment of patients with TB disease Contacts evaluated and started on treatment, as necessary |
Ongoing treatment of patients with TB disease Contacts evaluated and started on treatment, as necessary |
TB disease treatment completed Infected contacts continue on treatment for LTBI |
Contacts identified in previous year’s 1st quarter complete treatment |
Cohort review process begins, ongoing case management, case review meetings, cohort review practice session |
Cohort Review Session Begin to follow up on suggestions from cohort review |
Treatment completion rate presented for contacts of cases from previous 1st quarter
Continue to follow up on suggestions made during cohort review session |
This cycle is repeated throughout the year. Cohort review
sessions take place each quarter so that every TB case and contact
investigation receives a thorough review. An example of a
cohort review schedule is presented below.
Table 9: Example of a Cohort Review Schedule
Quarter Case Reported |
Quarter Case Reviewed |
1st (Jan-Mar 05) |
4th (Oct-Dec 05) |
2nd (Apr-Jun 05) |
1st (Jan-Mar 06) |
3rd (Jul-Sep 05) |
2nd (Apr-Jun 06) |
4th (Oct-Dec 05) |
3rd (Jul-Sep 06) |
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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