Medical Diagnostic Tests: A Review of Test Anatomy, Phases, and Statistical Treatment of Data (original) (raw)
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Evaluation of diagnostic tests
Clinical Epidemiology and Global Health, 2016
One of the most important tasks, a clinician has to perform when faced with a patient is that of reaching a diagnosis. Most astute clinicians use a thorough knowledge of literature along with a judicious use of diagnostic tests, good judgment, and a ready approach to organize the information. While newer diagnostic tests are continually coming into use, not much was said till recently about assessment of the test itself. The science of Clinical Epidemiology addresses the diagnostic process and the interpretation and evaluation of diagnostic data, both clinical and laboratory. c l i n i c a l e p i d e m i o l o g y a n d g l o b a l h e a l t h 4 (
Evaluating diagnostic tests: review
Southern African Journal of Anaesthesia and Analgesia, 2004
Anaesthesiologists are increasingly more involved in perioperative patient care wherein interpretation of special investigations is crucial to making therapeutic and prognostic decisions. Furthermore, anaesthetic journal publications increasingly rely on diagnostic tests, without paying sufficient attention to the methodology for evaluation of the predictive ability of these tests, particularly when conducting research. The purpose of this article is to provide an introduction to the principles underlying the objective appraisal of diagnostic tests and to provide basic tools for that purpose. Basic concepts about probability and conditional probability are introduced. An explanation is given how Bayes\' theorem can be used to apply new information to improve uncertainty about a diagnosis. Various indices of diagnostic accuracy are clarified using simple probabilistic notation applied to a 2x2 table from which they can be calculated. Two clinical examples are employed to illustra...
International Journal of Evidence-Based Healthcare, 2015
Systematic reviews are carried out to provide an answer to a clinical question based on all available evidence (published and unpublished), to critically appraise the quality of studies, and account for and explain variations between the results of studies. The Joanna Briggs Institute specializes in providing methodological guidance for the conduct of systematic reviews and has developed methods and guidance for reviewers conducting systematic reviews of studies of diagnostic test accuracy. Diagnostic tests are used to identify the presence or absence of a condition for the purpose of developing an appropriate treatment plan. Owing to demands for improvements in speed, cost, ease of performance, patient safety, and accuracy, new diagnostic tests are continuously developed, and there are often several tests available for the diagnosis of a particular condition. In order to provide the evidence necessary for clinicians and other healthcare professionals to make informed decisions regarding the optimum test to use, primary studies need to be carried out on the accuracy of diagnostic tests and the results of these studies synthesized through systematic review. The Joanna Briggs Institute and its international collaboration have updated, revised, and developed new guidance for systematic reviews, including systematic reviews of diagnostic test accuracy. This methodological article summarizes that guidance and provides detailed advice on the effective conduct of systematic reviews of diagnostic test accuracy.
Rational use of diagnostic tests for clinical decision making
Revista da Associação Médica Brasileira
SUMMARY OBJECTIVE: To assist clinicians to make adequate interpretation of scientific evidence from studies that evaluate diagnostic tests in order to allow their rational use in clinical practice. METHODS: This is a narrative review focused on the main concepts, study designs, the adequate interpretation of the diagnostic accuracy data, and making inferences about the impact of diagnostic testing in clinical practice. RESULTS: Most of the literature that evaluates the performance of diagnostic tests uses cross-sectional design. Randomized clinical trials, in which diagnostic strategies are compared, are scarce. Cross-sectional studies measure diagnostic accuracy outcomes that are considered indirect and insufficient to define the real benefit for patients. Among the accuracy outcomes, the positive and negative likelihood ratios are the most useful for clinical management. Variations in the study's cross-sectional design, which may add bias to the results, as well as other domai...
Application of statistics in establishing diagnostic certainty
Journal of athletic training
The examination and assessment of injured and ill patients leads to the establishment of a diagnosis. However, the tests and procedures used in health care, including procedures performed by certified athletic trainers, are individually and collectively imperfect in confirming or ruling out a condition of concern. Thus, research into the utility of diagnostic tests is needed to identify the procedures that are most helpful and to indicate the confidence one should place in the results of the test. The purpose of this report is to provide an overview of selected statistical procedures and the interpretation of data appropriate for assessing the utility of diagnostic tests with dichotomous (positive or negative) outcomes, with particular attention to the interpretation of sensitivity and specificity estimates and the reporting of confidence intervals around likelihood ratio estimates.