Diagnostic Tests Toolkit

Overview

This new volume in the Toolkit series is designed for clinicians and junior researchers who need to interpret the evidence for the effectiveness of the many diagnostic tests now available. Exceptionally user-friendly, this pocket-sized textbook realizes readers are not experts in diagnostic test interpretation. The authors cover a variety of issues, from how to design diagnostic test studies to understanding the results of diagnostic tests and interpreting the findings for clinical practice ...
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Diagnostic Tests Toolkit

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Overview

This new volume in the Toolkit series is designed for clinicians and junior researchers who need to interpret the evidence for the effectiveness of the many diagnostic tests now available. Exceptionally user-friendly, this pocket-sized textbook realizes readers are not experts in diagnostic test interpretation. The authors cover a variety of issues, from how to design diagnostic test studies to understanding the results of diagnostic tests and interpreting the findings for clinical practice and health care policy.
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Product Details

  • ISBN-13: 9780470657584
  • Publisher: Wiley
  • Publication date: 11/22/2011
  • Series: EBMT-EBM Toolkit Series , #5
  • Edition number: 2
  • Pages: 112
  • Product dimensions: 4.30 (w) x 6.70 (h) x 0.40 (d)

Meet the Author

Matthew Thompson, Oxford Centre for Monitoring and Diagnosis, Department of Primary Care Health Sciences, University of Oxford, UK & Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA

Ann Van den Bruel, Department of Primary Care Health Sciences, University of Oxford, UK

Series Editors:

Carl Heneghan, Centre for Evidence Based Medicine, Oxford, UK

Rafael Perera, Department of Primary Care, University of Oxford, UK

Douglas Badenoch, Minervation Ltd, Edinburgh, UK

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Table of Contents

Chapter 1 Diagnosis in evidencebased medicine

Diagnosis and screening

Screening

Symptoms

Signs and elicited symptoms

Bedside or pointofcare testing

Laboratory tests

Basic structure of studies of diagnostic tests

Further reading

Chapter 2 Evaluating new diagnostic tests

Technical accuracy (‘Can it work?’)

Place in the clinical pathway (‘Where does the test fit in the existing clinical pathway?’)

Ability of the test to diagnose or exclude the target condition (‘Does it work in patients?’)

The effect of the test on patient outcomes (‘Are patients better off?’)

Costeffectiveness (‘Is it worth the cost?’)

Further reading

Chapter 3 Asking an answerable clinical question

Defining a clinical question for diagnostic tests – PIRT

Further reading

Chapter 4 Finding the evidence: how to get the most from your searching

Combine textwords and thesaurus

Search filters for diagnostic accuracy studies

Further reading

Chapter 5 Selecting relevant studies

Selecting relevant studies

Assessing validity

What is the difference between bias and variability in diagnostic studies?

The ‘ideal’ diagnostic study

Flow charts of patients

Chapter 6 Sources of bias in diagnostic studies

Spectrum bias (also known as selection bias)

Verification bias (also called referral or workup bias)

Incorporation bias

Observer (or test review bias) bias

Differential reference bias (double gold standard)

What are the effects of the different designrelated biases?

Further reading

Chapter 7 Measures of discrimination of diagnostic tests

Two by two tables

Outcome measures

Which measure should you use and why?

The effect of prevalence on predictive values

Effect of time on diagnostic accuracy

Effect of severity of the target condition on diagnostic accuracy

The referral filter

Rules of thumb for interpreting likelihood ratios

Further reading

Chapter 8 Using diagnostic information in clinical practice

Validity of data

Problemsolving strategies that clinicians use in diagnosis

Action thresholds versus testing thresholds (‘Will the test change my management?’)

Methods for combining test results

Multivariable analyses

How are clinical prediction rules developed?

How to select a prediction rule for clinical practice

Further reading

Chapter 9 Screening tests

What are screening tests?

Different types of screening

Ideal study design for screening tests

Overdiagnosis

Further reading

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