Diagnostic Test Accuracy and Clinical Decision Making

Abstract

EditorialsDecember 16, 2008Diagnostic Test Accuracy and Clinical Decision MakingJohn Cornell, PhD, Associate Editor, Cynthia D. Mulrow, MD, MSc, Deputy Editor, and A. Russell Localio, PhD, Associate EditorJohn Cornell, PhD, Associate Editor, Cynthia D. Mulrow, MD, MSc, Deputy Editor, and A. Russell Localio, PhD, Associate EditorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-12-200812160-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Selecting a diagnostic test is a complex and sometimes bewildering task. Systematic reviews of diagnostic test accuracy provide only some of the essential information that physicians need. Choice of a diagnostic test is embedded within a dynamic multistage screening and decision-making context in which past clinical assessments and review of personal and family medical history determine the need for testing. For diagnostic tests, it is important to understand not only the test characteristics, such as sensitivity and specificity, but also the relative benefits and harms from actions in response to test results for subgroups of patients and the individual patient. ...References1. Moses LE, Shapiro D, and Littenberg B. Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. Stat Med. 1993;12:1293-316. [PMID: 8210827] CrossrefMedlineGoogle Scholar2. Irwig L, Tosteson AN, Gatsonis C, Lau J, Colditz G, Chalmers TC, et al. Guidelines for meta-analyses evaluating diagnostic tests. Ann Intern Med. 1994;120:667-76 LinkGoogle Scholar3. Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, et al. Standards for Reporting of Diagnostic Accuracy. Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD Initiative. Ann Intern Med. 2003;138:40-4 LinkGoogle Scholar4. 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The threshold approach to clinical decision making. N Engl J Med. 1980;302:1109-17. [PMID: 736663] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Disclosures: None disclosed.Corresponding Author: John E. Cornell, PhD, Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Reviews of Diagnostic Test Accuracy Mariska M.G. Leeflang , Jonathan J. Deeks , Constantine Gatsonis , Patrick M.M. Bossuyt , and Meta-analysis: Are 3 Questions Enough to Detect Unhealthy Alcohol Use? Levente Kriston , Lars Hölzel , Ann-Kristin Weiser , Michael M. Berner , and Martin Härter Challenges in Reporting Meta-analyses of Diagnostic Accuracy Studies Levente Kriston , Martin Härter , and Lars Hölzel Metrics Cited byChallenges in Reporting Meta-analyses of Diagnostic Accuracy StudiesLevente Kriston, PhD, Martin Härter, MD, PhD, and Lars Hölzel, MA December 16, 2008Volume 149, Issue 12Page: 904-906KeywordsAlcoholismAlcoholsAntiretroviral therapyDecision analysisDecision makingHIVHealth care quality assessmentInformation technologyInpatientsLibrariesPopulation statisticsSpecificityStatistical methodsStatistical modelsSystematic reviewsVision ePublished: 16 December 2008 Issue Published: December 16, 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

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