Article
Developments on tackling diagnostic test accuracy recommendations by the GRADE Working Group
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Published: | July 10, 2012 |
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Background: Typical management questions include questions about diagnosis. Indeed, applying a diagnostic test or a diagnostic strategy to a patient or a population is an action with many similarities to other interventions. Therefore, recommendations concerning diagnostic testing share the fundamental logic of recommendations for therapeutic and other interventions, such as screening. However, diagnostic questions also present unique challenges.
Context: This presentation will describe, on the basis of real examples from the World Health Organization (WHO), how systematic reviewers and guideline developers using GRADE assess and present the results and the quality of a body of evidence of diagnostic accuracy studies. We present an overview of the new developments of the approach and review the presentation of results of a body of evidence for diagnostic test accuracy studies.
Description of best practice: We will describe how systematic reviewers and guideline developers using GRADE assess and present the results and the quality of a body of evidence of diagnostic accuracy studies. While several of the criteria (e.g. imprecision, publication bias and magnitude of the association) for rating the quality of evidence require further elaboration in methodological research, the general factors that require consideration are presented here. Judgments need to be made on the basis of what is known so far, but discoveries will further operationalize these criteria.
Lessons for guideline developers, adaptors, implementers, and/or users: We will address how guideline developers may approach the link between diagnostic test accuracy data and presumed patient important outcomes to develop recommendations.