Systematic reviews of diagnostic test evaluations: What's behind the scenes?

Humphrey, Peter R.
November 2004
ACP Journal Club;Nov/Dec2004, Vol. 141 Issue 3, pA-14
Academic Journal
The article presents systematic reviews of diagnostic test evaluations. The article adds that the inter- and intraobserver variability of the gold standard must be known before one can assess any new test. No new test can be expected to match the gold standard more closely than the inter- and intraobserver variability for that gold standard. Failure to appreciate this limitation will result in a new test not matching the gold standard, even when the new test is as good, and sometimes better than, die gold standard.


Related Articles

  • Clinical myths. Barraclough, Kevin // BMJ: British Medical Journal (International Edition);6/3/2006, Vol. 332 Issue 7553, p1341 

    The article comments on a "feel" for practicing medicine that grows with clinical experience. The author relates his views on medical education and focuses on the topic of disease presentation and the predictability of clinical features. The author says that as a student he was taught the...

  • The dawn of a new era: Transforming our domestic response to hepatitis B & C. Activity 6: Reports from today's health care environment on the implementation of screening, diagnosis, and treatment recommendations.  // Journal of Family Practice;Apr2010 Supplement, Vol. 59, pS43 

    The article discusses reports from the Veterans health Administration (VHA), correctional system, and Keiser Permanente (KP) system regarding the health care implementation of screening, diagnosis, and treatment recommendations in the U.S. It also focuses on VHA's implementation recommendations,...

  • Psychosocial Influences on Low Back Pain, Disability, and Response to Treatment. Hill, Jonathan C.; Fritz, Julie M. // Physical Therapy;May2011, Vol. 91 Issue 5, p712 

    Evidence suggests that psychosocial factors have an influence on the outcome of physical therapy treatment and that the extent of their influence differs considerably among patients. As a consequence, substantial research efforts are focused on developing new clinical tools designed to identify...

  • A decision-analytic approach to define poor prognosis patients: a case study for non-seminomatous germ cell cancer patients. van Dijk, Merel R.; Steyerberg, Ewout W.; Habbema, J. Dik F. // BMC Medical Informatics & Decision Making;2008, Vol. 8 Issue 1, Special section p1 

    Background: Classification systems may be useful to direct more aggressive treatment to cancer patients with a relatively poor prognosis. The definition of 'poor prognosis' often lacks a formal basis. We propose a decision analytic approach to weigh benefits and harms explicitly to define the...

  • Three puzzling cases. Dunea, George // BMJ: British Medical Journal (International Edition);7/10/2004, Vol. 329 Issue 7457, p119 

    Discusses how the clinicopathological conference is a time honored exercise in which a participant is given a clinical protocol and tries make a diagnosis. The cases which are often puzzling; Examples including what to make of a wasted man, deathly pale, with web-like thin hair, and exaggerated...

  • Script Concordance Tests: Guidelines for Construction. Fournier, Jean Paul; Demeester, Anne; Charlin, Bernard // BMC Medical Informatics & Decision Making;2008, Vol. 8 Issue 1, Special section p1 

    Background: SCT is used to assess clinical reasoning in ambiguous or uncertain situations. It allows testing on real-life situations that are not adequately measured with current tests. It probes the multiple judgments that are made in the clinical reasoning process. Scoring reflects the degree...

  • Evidence does not support clinical screening of literacy. Paasche-Orlow, Michael; Wolf, Michael; Paasche-Orlow, Michael K; Wolf, Michael S // JGIM: Journal of General Internal Medicine;Jan2008, Vol. 23 Issue 1, p100 

    Limited health literacy is a significant risk factor for adverse health outcomes. Despite controversy, many health care professionals have called for routine clinical screening of patients' literacy skills. Whereas brief literacy screening tools exist that with further evaluation could...

  • Conflicts on Prognosis Occur Over Half the Time Between Physicians and Surrogate Decision-Makers.  // Medical Ethics Advisor;Nov2016, Vol. 32 Issue 11, p121 

    The article looks at a study regarding the conflicts between physicians and surrogate decision-makers involving the patient's prognosis and the need to maintain hope was a common reason for surrogates being more optimistic about prognosis than physicians.

  • Validação de diagnóstico de enfermagem: reflexão sobre dificuldades enfrentadas por pesquisadores. Carvalho, Emilia Campos de; Mello, Alexandra de Sousa; Napoleão, Anamaria Alves; Bachion, Maria Márcia; Dalri, Maria Célia Barcellos; Canini, Silvia Rita Marin da Silva // Revista Eletronica de Enfermagem;2008, Vol. 10 Issue 1, p235 

    Given the complexity of diagnosis validation studies, the criteria suggested for each phase of this process and those usually adopted by researchers in the development of their studies, the authors considered it appropriate to identify, in a reflexive way, points related to the range,...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics