Assessment of the functioning of respiratory organs in patients with tuberculosis during medical and social examination and disability assessment

Objective. To conduct an analysis of limitations in life activities and associated impairments of bodily functions in patients with tuberculosis of the respiratory organs, to develop and validate objective rules for predicting expert assessments of the degree of severity of limitations in categories of life activities during medical and social assessments and the establishment of disability.

Materials and methods. The study included 149 patients with respiratory tuberculosis, who were referred for the first time for medical and social examination to determine disability, and 75 patients in the control group who successfully completed the course of treatment. The study was conducted at the Minsk City Medical and Rehabilitation Expert Commission, the Minsk Regional Тtuberculosis Dispensary, and the Consultative Polyclinic Department of the National Science and Practice Centre of Medical Assessment and Rehabilitation from 2017 to 2024. The mean age (SE) of the patients in the study cohort was 47.4 (0.71) years.

Results. An analysis of the variability of activity limitations in patients with pulmonary tuberculosis revealed that the “work capacityˮ category is dominant in the assessment of functioning and is key in determining disability. However, the “independent mobilityˮ and “self-careˮ categories also demonstrate significant variability and are important for expert assessment when determining disability. For the “independent mobilityˮ and “self-careˮ categories, respiratory function emerged as the most significant predictor in the expert assessment of the severity of limitations, with an accuracy of 92.6 % and 94.6 % in the training set and 90.7 % and 93.3 % in the test set. For the “work capacityˮ category, immune function emerged as the primary predictor, with an accuracy of 96.6 % in the training set and 97.3 % in the test set, confirming their high stability. Validation on an independent test set demonstrated a slight decrease in accuracy (difference ≤ 1.9 percentage points, p = 0.61), indicating the absence of overfitting, high reproducibility, and clinical suitability of the developed rules. The results confirm their reliability and potential for practical application in expert practice.

Сonclusion. The study proposes simple algorithms based on assessing the severity of respiratory and immune dysfunction for objective expert assessment of disability in patients with respiratory tuberculosis. Their implementation facilitates the standardization of the medical and social assessment process and improves the quality of expert decisions, thereby facilitating informed determination of disability status and streamlining the development of individualized rehabilitation and habilitation programs for individuals with disabilities.

1. Aksenovoj V.A., Bozhkova I.A., Balasanyanc G.S., eds. Anti-tuberculosis dispensary: an effective interdisciplinary concept. Мoscow: GEOTAR-Media; 2023. 432. (in Russian)

2. Danilov A.N., Morozova T.I., Komleva N.E., Salina T.Yu. Tuberculosis and human quality of life. Saratov: Izd. centr Sarat. gos. med. un-ta im. V. I. Razumovskogo; 2020. 115. (in Russian)

3. Smychek V.B., Kazakevich D.S., Gorustovich L.N. Expertise of professional work capacity. Minsk: Kolograd; 2025. 221. (in Russian)

4. Smychek V.B. Medical rehabilitation: history of formation, modern condition, prospects of the development. Fizicheskaya i reabilitacionnaya medicina. 2020; 2(2): 7–17. (in Russian)