Abstract
We have learned how to quantify the accuracy of dichotomous (Chapter 2) and multilevel (Chapter 3) tests. In this chapter, we turn to critical appraisal of studies of diagnostic test accuracy, with an emphasis on problems with study design that affect the interpretation or credibility of the results. After a general discussion of an approach to studies of diagnostic tests, we will review some common biases to which studies of test accuracy are uniquely or especially susceptible and conclude with an introduction to systematic reviews of test accuracy studies.
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