Reem A Mustafa1, Wojtek Wiercioch2, Adrienne Cheung3, Barbara Prediger4, Jan Brozek5, Patrick Bossuyt6, Amit X Garg7, Monika Lelgemann8, Diedrich Büehler9, Holger J Schünemann10. 1. Department of Health Research Methods, Evidence and Impact (formerly "Clinical Epidemiology and Biostatistics"), McMaster University, 1280 Main Street West Hamilton, ON L8S 4K1, Canada; Departments of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, MS3002, Kansas City, KS 66160, USA. 2. Department of Health Research Methods, Evidence and Impact (formerly "Clinical Epidemiology and Biostatistics"), McMaster University, 1280 Main Street West Hamilton, ON L8S 4K1, Canada. 3. Faculty of Medicine, University of British Colombia, 2312 Pandosy St, Kelowna, BC V1Y 1T3, Canada. 4. Faculty of Management, Economics and Social Science, University of Cologne, Aachener Str. 209, 50931 Cologne, Germany. 5. Department of Health Research Methods, Evidence and Impact (formerly "Clinical Epidemiology and Biostatistics"), McMaster University, 1280 Main Street West Hamilton, ON L8S 4K1, Canada; Department of Medicine, McMaster University, 1280 Main Street West Hamilton, ON L8S 4K1, Canada. 6. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, 2593 HW Den Haag, Amsterdam, The Netherlands. 7. Department of Health Research Methods, Evidence and Impact (formerly "Clinical Epidemiology and Biostatistics"), McMaster University, 1280 Main Street West Hamilton, ON L8S 4K1, Canada; Department of Medicine, Western University, Victoria Hospital, Rm. E6-117, London, ON N6A 5A5, Canada. 8. Medizinischer Dienst des Spitzenverbandes Bund der Kranken-kassen e.V. (MDS), Theodor Althoff-Str. 47, 45133 Essen, Germany. 9. Abteilung Medizin. GKV, 10117 Berlin, Germany. 10. Department of Health Research Methods, Evidence and Impact (formerly "Clinical Epidemiology and Biostatistics"), McMaster University, 1280 Main Street West Hamilton, ON L8S 4K1, Canada; Department of Medicine, McMaster University, 1280 Main Street West Hamilton, ON L8S 4K1, Canada. Electronic address: schuneh@mcmaster.ca.
Abstract
OBJECTIVES: In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. STUDY DESIGN AND SETTING: We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. RESULTS: We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. CONCLUSION: This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions.
OBJECTIVES: In this first of a series of five articles, we provide an overview of how and why healthcare-related tests and diagnostic strategies are currently applied. We also describe how our findings can be integrated with existing frameworks for making decisions that guide the use of healthcare-related tests and diagnostic strategies. STUDY DESIGN AND SETTING: We searched MEDLINE, references of identified articles, chapters in relevant textbooks, and identified articles citing classic literature on this topic. RESULTS: We provide updated frameworks for the potential roles and applications of tests with suggested definitions and practical examples. We also discuss study designs that are commonly used to assess tests' performance and the effects of tests on people's health. These designs include diagnostic randomized controlled trials and retrospective validation. We describe the utility of these and other currently suggested designs, which questions they can answer and which ones they cannot. In addition, we summarize the challenges unique to decision-making resulting from the use of tests. CONCLUSION: This overview highlights current challenges in the application of tests in decision-making in healthcare, provides clarifications, and informs the proposed solutions.
Authors: Robert I Liem; Sophie Lanzkron; Thomas D Coates; Laura DeCastro; Ankit A Desai; Kenneth I Ataga; Robyn T Cohen; Johnson Haynes; Ifeyinwa Osunkwo; Jeffrey D Lebensburger; James P Lash; Theodore Wun; Madeleine Verhovsek; Elodie Ontala; Rae Blaylark; Fares Alahdab; Abdulrahman Katabi; Reem A Mustafa Journal: Blood Adv Date: 2019-12-10
Authors: M Hassan Murad; Robert I Liem; Eddy S Lang; Elie A Akl; Joerg J Meerpohl; Michael R DeBaun; John F Tisdale; Amanda M Brandow; Sophie M Lanzkron; Stella T Chou; Starr Webb; Reem A Mustafa Journal: Blood Adv Date: 2019-12-10
Authors: Ingrid Arevalo-Rodriguez; Karen R Steingart; Andrea C Tricco; Barbara Nussbaumer-Streit; David Kaunelis; Pablo Alonso-Coello; Susan Baxter; Patrick M Bossuyt; José Ignacio Emparanza; Javier Zamora Journal: BMC Med Res Methodol Date: 2020-05-13 Impact factor: 4.615
Authors: Fiona M Walter; Matthew J Thompson; Ian Wellwood; Gary A Abel; William Hamilton; Margaret Johnson; Georgios Lyratzopoulos; Michael P Messenger; Richard D Neal; Greg Rubin; Hardeep Singh; Anne Spencer; Stephen Sutton; Peter Vedsted; Jon D Emery Journal: BMC Cancer Date: 2019-06-14 Impact factor: 4.430