Abstract
In the clinical assessment of a medical test, the evaluation of its diagnostic accuracy is an essential step. In an evaluation of diagnostic accuracy, the results of the test are compared with the results of the reference standard in the same patients. Yet, one cannot unconditionally take the results from any particular study at face value. Many authors have pointed out the multiple risks of bias in diagnostic accuracy studies (1,2). Critical appraisal of published studies is therefore essential. Unfortunately, researchers in many published studies fail to report essential elements of study design and conduct, making critical appraisal hazardous, if not impossible (3,4). Authors fail to mention the inclusion criteria, how they identified eligible patients, whether all patients underwent both the test under evaluation and the reference standard, and whether the same standard was used in all patients. They do not always mention how many uninterpretable results there were and how these were accounted for in the analysis.
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