Abstract
ABSTRACTTopic development and structuring a systematic review of diagnostic tests are complementary processes. The goals of a medical test review are to identify and synthesize evidence to evaluate the impacts alternative testing strategies on health outcomes and to promote informed decisionmaking. A common challenge is that the request for a review may state the claim for the test ambiguously. Due to the indirect impact of medical tests on clinical outcomes, reviewers need to identify which intermediate outcomes link a medical test to improved clinical outcomes. In this paper, we propose the use of five principles to deal with challenges: the PICOTS typology (patient population, intervention, comparator, outcomes, timing, setting), analytic frameworks, simple decision trees, other organizing frameworks and rules for when diagnostic accuracy is sufficient.
Highlights
This work should be done in conjunction with the principal users
et al Improving the process of developing technical reports for health care decision makers
how a test might be of value in practice
Summary
Chapter 2: Medical Tests Guidance (2) Developing the Topic and Structuring Systematic Reviews of Medical Tests: Utility of PICOTS, Analytic Frameworks, Decision Trees, and Other Frameworks. Topic development and structuring a systematic review of diagnostic tests are complementary processes. Developing the topic creates the foundation and structure of an effective systematic review This process includes understanding and clarifying a claim about a test (how a test might be of value in practice) and establishing the key questions to guide decisionmaking related to the claim. As evidence-based practice centers (EPCs) develop and refine the topic, the structure of the review should become clearer. While this paper is intended to serve as a guide for EPCs, the processes described here are relevant to other systematic reviewers and a broad spectrum of stakeholders including patients, clinicians, caretakers, researchers, funders of research, government, employers, health care payers and industry, as well as the general public.
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