Archive for the ‘Pulmonary Medicine’ Category

In the final analysis, however, relative diagnostic accuracies of competing tests are not the ultimate measure of a test’s clinical value. The incremental value of a test is defined by how a test interacts with other available diagnostic approaches in terms of relative diagnostic accuracy, relative costs, feasibility, and patient risk or invasiveness. These measures […]

Deficiencies were also noted in study design and data analysis techniques when the articles reported the results of head-to-head comparisons of two or more tests relative to a reference standard. Head-to-head comparisons of diagnostic tests require that all of the evaluated tests be applied to all of the study patients or different tests be applied […]

More than 80% of studies fulfilled the standards for reporting indeterminate or uninterpretable test results, but only 67% of articles indicated how indeterminate results were incorporated into measures of test accuracy. Exclusion of indeterminate or uninterpretable results from analysis results in considerable bias unless they occur in a random manner. Studies also commonly failed in […]

Ninety percent (90%) of articles evaluated diagnostic tests in indicated rather than convenience populations of patients. Unfortunately, only 54% of the articles described the techniques used to enter patients into the studies, which would allow an assessment of the degree to which sampling bias affected the study results. Also, only 61% of articles adequately described the spectrum composition (“case […]

Most of the reviewed articles also failed to ensure against test review bias. This bias occurs when a lack of suitable blinding of the reviewers who interpret the evaluated test or the reference standard results prevents an independent assessment. Test review bias is especially serious in investigations wherein the reference standard requires subjective interpretation and […]

Study raters Kappa values for the assessed standards between the two primary raters ranged from 0.72 to 0.92 (“substantial” to “almost perfect agreement”). Discussion The increasing number, cost, and sophistication of diagnostic tests and their significant impact on patient care require that new tests undergo rigorous assessment before they are adopted into clinical practice. The […]

Table 2 shows the proportion of studies that fulfilled the standards for study design. The denominator used to calculate proportions was 41 studies except if a standard applied only to a subgroup of the 41 study articles. The first 12 of the 13 standards listed in Table 2 applied to all of the study articles. […]

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Blog invites submissions of review articles, reports on clinical techniques, case reports, conference summaries, and articles of opinion pertinent to the control of pain and anxiety in dentistry.