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Chapter 7: grading a body of evidence on diagnostic tests.

Publication ,  Journal Article
Singh, S; Chang, SM; Matchar, DB; Bass, EB
Published in: J Gen Intern Med
June 2012

INTRODUCTION: Grading the strength of a body of diagnostic test evidence involves challenges over and above those related to grading the evidence from health care intervention studies. This chapter identifies challenges and outlines principles for grading the body of evidence related to diagnostic test performance. CHALLENGES: Diagnostic test evidence is challenging to grade because standard tools for grading evidence were designed for questions about treatment rather than diagnostic testing; and the clinical usefulness of a diagnostic test depends on multiple links in a chain of evidence connecting the performance of a test to changes in clinical outcomes. PRINCIPLES: Reviewers grading the strength of a body of evidence on diagnostic tests should consider the principle domains of risk of bias, directness, consistency, and precision, as well as publication bias, dose response association, plausible unmeasured confounders that would decrease an effect, and strength of association, similar to what is done to grade evidence on treatment interventions. Given that most evidence regarding the clinical value of diagnostic tests is indirect, an analytic framework must be developed to clarify the key questions, and strength of evidence for each link in that framework should be graded separately. However if reviewers choose to combine domains into a single grade of evidence, they should explain their rationale for a particular summary grade and the relevant domains that were weighed in assigning the summary grade.

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Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

June 2012

Volume

27 Suppl 1

Issue

Suppl 1

Start / End Page

S47 / S55

Location

United States

Related Subject Headings

  • Review Literature as Topic
  • Publication Bias
  • Outcome and Process Assessment, Health Care
  • Humans
  • Guidelines as Topic
  • General & Internal Medicine
  • Evidence-Based Medicine
  • Diagnostic Techniques and Procedures
  • 4206 Public health
  • 4203 Health services and systems
 

Citation

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Singh, S., Chang, S. M., Matchar, D. B., & Bass, E. B. (2012). Chapter 7: grading a body of evidence on diagnostic tests. J Gen Intern Med, 27 Suppl 1(Suppl 1), S47–S55. https://doi.org/10.1007/s11606-012-2021-9
Singh, Sonal, Stephanie M. Chang, David B. Matchar, and Eric B. Bass. “Chapter 7: grading a body of evidence on diagnostic tests.J Gen Intern Med 27 Suppl 1, no. Suppl 1 (June 2012): S47–55. https://doi.org/10.1007/s11606-012-2021-9.
Singh S, Chang SM, Matchar DB, Bass EB. Chapter 7: grading a body of evidence on diagnostic tests. J Gen Intern Med. 2012 Jun;27 Suppl 1(Suppl 1):S47–55.
Singh, Sonal, et al. “Chapter 7: grading a body of evidence on diagnostic tests.J Gen Intern Med, vol. 27 Suppl 1, no. Suppl 1, June 2012, pp. S47–55. Pubmed, doi:10.1007/s11606-012-2021-9.
Singh S, Chang SM, Matchar DB, Bass EB. Chapter 7: grading a body of evidence on diagnostic tests. J Gen Intern Med. 2012 Jun;27 Suppl 1(Suppl 1):S47–S55.
Journal cover image

Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

June 2012

Volume

27 Suppl 1

Issue

Suppl 1

Start / End Page

S47 / S55

Location

United States

Related Subject Headings

  • Review Literature as Topic
  • Publication Bias
  • Outcome and Process Assessment, Health Care
  • Humans
  • Guidelines as Topic
  • General & Internal Medicine
  • Evidence-Based Medicine
  • Diagnostic Techniques and Procedures
  • 4206 Public health
  • 4203 Health services and systems