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rdf:type
lifeskim:mentions
pubmed:dateCreated
2008-9-22
pubmed:abstractText
Making an accurate diagnosis is essential to ensure that a patient receives appropriate treatment and correct information regarding their prognosis. Characteristics of diagnostic tests are quantified in test accuracy studies, but many such studies have methodological flaws. The HSRC evidence-based diagnosis programme has focused on methods for systematic reviews of test accuracy studies, and the wider context in which tests are ordered and interpreted. We carried out a range of projects relating to literature searching, quality assessment, meta-analysis, presentation of results, and interactions between doctors and patients during the diagnostic process. We have shown that systematic reviews of test accuracy studies should search a range of databases and that current diagnostic filters do not have sufficient accuracy to be used in test accuracy reviews. Summary quality scores should not be used in test accuracy reviews; the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Reviews (QUADAS) tool for assessing test accuracy studies is acceptable for quality assessment. We have shown that the hierarchical summary receiver operating characteristic (HSROC) and bivariate models for meta-analysis of test accuracy are statistically equivalent in many circumstances, and have developed an add-on module for the statistical software package Stata that enables these statistically rigorous models to be fitted by those without expert statistical knowledge. Three areas that would benefit from further research are literature searching, synthesis of results from individual patient data and presentation of results.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
H
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
1355-8196
pubmed:author
pubmed:issnType
Print
pubmed:volume
13 Suppl 3
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
57-63
pubmed:meshHeading
pubmed:year
2008
pubmed:articleTitle
Evidence-based diagnosis.
pubmed:affiliation
Department of Social Medicine, University of Bristol, Bristol, UK. Penny.whiting@bristol.ac.uk
pubmed:publicationType
Journal Article