Reporting Of Diagnostic Accuracy Studies Research Articles

Protocol for Conducting a Systematic Review on Diagnostic Accuracy in Clinical Research

In the landscape of modern medicine, the ability to accurately diagnose various clinical conditions is paramount. As new diagnostic tools continue to emerge, their accuracy must be rigorously assessed before clinical implementation. This paper introduces a systematic review protocol tailored for diagnostic accuracy studies, drawing inspiration from a review on dysphagia screening in post-stroke patients. The protocol, designed with precision and transparency at its core, facilitates a thorough synthesis of evidence, employing tools such as the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) and the Standards for Reporting of Diagnostic Accuracy Studies (STARD) checklist for robust evaluation. The protocol emphasizes registration with the PROSPERO database and adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The systematic search approach encompasses a comprehensive exploration of databases and precise keyword combinations. Distinctive inclusion and exclusion criteria, coupled with a dual-reviewer methodology, ensure the selection of high-quality studies. This framework has the potential to serve as a benchmark for systematic reviews in diagnostic accuracy, highlighting the importance of standardization, transparency, and adaptability in clinical research. This approach paves the way for a research methodology that delves deeper into diagnostic tools across various clinical scenarios, promoting evidence-based advancements in patient care.

Diagnostic Performance of Ultrasonography for Diabetic Foot Osteomyelitis.

Objective: This study aims to analyze the potential diagnostic capability of ultrasonography (US) in detecting diabetic foot osteomyelitis (DFO) in patients with diabetic foot ulcers (DFUs). Approach: A 1-year prospective study was conducted on 47 consecutive patients with active DFUs and suspicion of DFO at a specialized diabetic foot unit. The following ultrasonographic features were evaluated at baseline: (1) periosteal reaction; (2) periosteal elevation; (3) cortical disruption; (4) sequestrum; and (5) positive power Doppler. The primary outcome measure aimed to establish the effectiveness of ultrasonographic features compared with aseptic bone culture for diagnosing DFO. Receiver operating characteristic (ROC) curves were utilized to evaluate the diagnostic performance of ultrasonographic features. Sample size could not be determined as it is the first study to assess ultrasonographic features for the diagnosis of DFO. The research adhered to the guidelines for diagnostic accuracy studies (Standards for Reporting of Diagnostic Accuracy Studies [STARD] 2015). Results: All patients (n = 24) diagnosed with DFO exhibited positive power Doppler, resulting in a sensitivity (S) and specificity (SP) of 1 and an area under the curve (AUC) of 1 (p < 0.001 [1-1]). Cortical disruption was present in 23 patients (95.8%) with DFO, yielding an S of 0.93, SP of 1, and AUC of 0.96 (p < 0.001 [0.88-1]). Innovation: It validates the diagnostic value of US for DFO as it is the first and largest study of its kind to establish a clear reference standard to guide clinician decision-making. Conclusion: This study demonstrates the effectiveness of cortical disruption and positive power Doppler in assessing DFO through US.

Publications on the diagnostic accuracy of dermatopathology tests: A cross-sectional quality analysis.

Ancillary diagnostic tests are frequent in dermatopathology practice. Publications on their accuracy influence their utilization. The transparency and completeness of these publications are unknown. We performed a cross-sectional study on diagnostic accuracy studies in dermatopathology published between 2020 and 2022 for compliance with Standards for Reporting of Diagnostic Accuracy Studies (STARD) and the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). 14.67 ± 3.02 STARD items were reported in 62 publications (range, 9.5-23.5 out of the recommended total of 30). More items were reported in high-impact factor journals (16.01 vs. 13.32, p = 0.0002) and journals that endorsed STARD in their author instructions (17.22 vs. 14.11, p = 0.0039). Less than 10% of publications reported quantifiable hypotheses, sample size calculations, flow diagrams, or study registrations. The risk of bias by our analysis of QUADAS-2 criteria was high or uncertain for index test interpretation (36/62, 58%) and patient selection (44/62, 71%). Publications on dermatopathology tests are exploratory studies without prespecified hypotheses or study designs. They do not meet the criteria for transparent reporting. We suggest that medical journal leadership should consider updating their instructions with more explicit guidance on recommended manuscript elements.

Adherence to Complication Reporting for Randomized Controlled Trials Contained in Clinical Practice Guidelines for the Management of Carpal Tunnel Syndrome

Randomized controlled trials (RCTs) are frequently used in creating recommendations contained within clinical practice guidelines (CPGs). However, investigations outside of hand surgery have reported that RCTs within CPGs infrequently report complications and harms-related data. Our purpose was to assess adherence to complication reporting and harms-related outcomes contained in the Consolidated Standards for Reporting (CONSORT) Extension of Harms and Standards for Reporting of Diagnostic Accuracy Studies (STARD) reporting checklists for RCTs within the American Academy of Orthopaedic Surgery (AAOS) CPGs for carpal tunnel syndrome (CTS). We identified all RCTs within the AAOS CTS CPGs. All therapeutic RCTs and diagnostic studies were included. We used the CONSORT Harms Checklist criteria to assess adherence to the reporting of adverse events for therapeutic RCTs and the STARD criteria to assess the diagnostic accuracy of the articles. We defined adequate compliance as adherence to ≥50% of the checklist items. We identified 82 therapeutic RCTs and 90 diagnostic accuracy articles within the AAOS CTS CPG. For therapeutic RCTs, we found that the average compliance with the published checklists was 19%. For diagnostic studies, the average compliance with checklists was found to be 55%. Eleven therapeutic RCTs (13%) and 60 diagnostic studies (67%) were determined to have adequate compliance for the CONSORT and STARD checklists, respectively. Randomized controlled trials in the AAOS CPGs for CTS have low compliance with the CONSORT Extension for Harms Checklist. Although the overall adherence to the items published in the STARD statement for diagnostic accuracy evaluation remains higher, future efforts should be made to improve the adherence rates to both checklists. Improved standardization of complication reporting may aid in comparing outcomes across multiple clinical investigations of upper-extremity procedures.

Methods and results of studies on reporting guideline adherence are poorly reported: a meta-research study

ObjectivesWe investigated recent meta-research studies on adherence to four reporting guidelines to determine the proportion that provided (1) an explanation for how adherence to guideline items was rated and (2) results from all included individual studies. We examined conclusions of each meta-research study to evaluate possible repetitive and similar findings. Study Design and SettingA cross-sectional meta-research study. MEDLINE (Ovid) was searched on July 5, 2022 for studies that used any version of the Consolidated Standards of Reporting Trials, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Standards for the Reporting of Diagnostic Accuracy Studies, or Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines or their extensions to evaluate reporting. ResultsOf 148 included meta-research studies published between August 2020 and June 2022, 14 (10%, 95% confidence interval [CI] 6%–15%) provided a fully replicable explanation of how they coded the adherence ratings and 49 (33%, 95% CI 26%–41%) completely reported individual study results. Of 90 studies that classified reporting as adequate or inadequate in the study abstract, six (7%, 95% CI 3%–14%) concluded that reporting was adequate, but none of those six studies provided information on how items were coded or provided item-level results for included studies. ConclusionAlmost all included meta-research studies found that reporting in health research is suboptimal. However, few of these reported enough information for verification or replication.

Transparency and completeness of reporting of depression screening tool accuracy studies: A meta-research review of adherence to the Standards for Reporting of Diagnostic Accuracy Studies statement.

Accurate and complete study reporting allows evidence users to critically appraise studies, evaluate possible bias, and assess generalizability and applicability. We evaluated the extent to which recent studies on depression screening accuracy were reported consistent with Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement requirements. MEDLINE was searched from January 1, 2018 through May 21, 2021 for depression screening accuracy studies. 106 studies were included. Of 34 STARD items or sub-items, the number of adequately reported items per study ranged from 7 to 18 (mean=11.5, standard deviation [SD]=2.5; median=11.5), and the number inadequately reported ranged from 3 to 17 (mean=10.1, SD=2.5; median=10.0). There were eight items adequately reported, seven partially reported, 11 inadequately reported, and four not applicable in ≥50% of studies; the remaining four items had mixed reporting. Items inadequately reported in ≥70% of studies related to the rationale for index test cut-offs examined, missing data management, analyses of variability in accuracy results, sample size determination, participant flow, study registration, and study protocol. Recently published depression screening accuracy studies are not optimally reported. Journals should endorse and implement STARD adherence.

STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration

Diagnostic accuracy studies are, like other clinical studies, at risk of bias due to shortcomings in design and conduct, and the results of a diagnostic accuracy study may not apply to other patient groups and settings. Readers of study reports need to be informed about study design and conduct, in sufficient detail to judge the trustworthiness and applicability of the study findings. The STARD statement (Standards for Reporting of Diagnostic Accuracy Studies) was developed to improve the completeness and transparency of reports of diagnostic accuracy studies. STARD contains a list of essential items that can be used as a checklist, by authors, reviewers and other readers, to ensure that a report of a diagnostic accuracy study contains the necessary information. STARD was recently updated. All updated STARD materials, including the checklist, are available at http://www.equator-network.org/reporting-guidelines/stard. Here, we present the STARD 2015 explanation and elaboration document. Through commented examples of appropriate reporting, we clarify the rationale for each of the 30 items on the STARD 2015 checklist, and describe what is expected from authors in developing sufficiently informative study reports. Present article is Russian-language translation of the original manuscript edited by Doctor of Medicine R.T. Saygitov.Present translation was first published in Digital Diagnostics. doi: 10.17816/DD71031. It is published with minor changes related to the literary editing of the translation itself.

P-318 Application of the Standards for Reporting of Diagnostic Accuracy studies (STARD) 2015 to research on blood biomarkers of endometriosis

Abstract Study question How completely reported are studies on blood biomarkers of endometriosis, according to their adherence to the STARD 2015 checklist? Summary answer Studies on blood biomarkers of endometriosis are often incompletely reported, with only an overall adherence rate of 28.5% to the STARD 2015 checklist. What is known already Laparoscopy, the gold standard diagnostic method for determining endometriosis, is invasive, expensive, requires anesthesia and is associated with risk of vascular/ visceral damage. Therefore, less invasive diagnostics are needed. Many studies have been published on blood biomarkers of endometriosis with variable methodological quality. To assess applicability and risk of bias of diagnostic accuracy studies, completeness of study reporting must first be ensured. STARD 2015 checklist was introduced to guide reporting of diagnostic accuracy studies. The degree of adherence in studies on blood biomarkers of endometriosis to this 30-item STARD 2015 checklist is not known. Study design, size, duration Our systematic review included 126 studies from the 2016 Cochrane review on blood biomarkers of endometriosis. We added 84 more studies after updating the search in Pubmed, CINHAL and Web of Science, for the period May 2015- July 2021, with the keywords: endometriosis and biomarkers/ non-invasive diagnosis/ laboratory tests/ blood test, using the same eligibility criteria as in the Cochrane review. Totally, 210 studies were assessed for adherence to STARD 2015 checklist. Participants/materials, setting, methods STARD 2015 items were scored 1 if reported, or 0 if unreported. Each study received an adherence rate (percent of reported STARD items). Every item received individual item’s reporting rate (percent of its reporting across studies). Effect of publication year on study adherence and item reporting rates was examined by linear and logistic regressions, respectively. Journal impact factors were classified to tertiles and their relation to study adherence rate examined with one-way ANOVA. Main results and the role of chance Adherence rate was 28.5%, with 8.8± 3.1 reported items per study (range 2-18). Study adherence to STARD 2015 significantly increased with advancing publication years [r = 0.344 (95% CI 0.219 – 0.458), p &amp;lt; 0.001]. Journal impact factor had no effect on adherence to STARD 2015 (P = 0.274). Items with reporting rates &amp;gt;50% included #1 (identification as diagnostic accuracy study), #5 (prospective or retrospective), #7 (participants identification), #10a (index test), #10b (reference standard), #14 (diagnostic accuracy measures), #21a (disease severity), #21b (alternate diagnosis), and #22 (time between index test and reference standard). Items with reporting rates 20 to 50% included #6 (eligibility criteria), #8 (when/ where participants identifies), #12a (test positivity cutoff), #20 (participant characteristics) and #26 (limitations). Reporting rate &amp;lt; 20% seen in items #3 (background), #4 (hypothesis), #9 (consecutive /random recruitment), #13a/b (blinding of index test/ reference standard performers), #15 (intermediate results), #16 (missing data), #17 (analysis of variability), #18 (sample size), #19 (flow diagram), #23 (cross tabulation), #24 (diagnostic accuracy precision), #25 (adverse events), #27 (implications), #28 (registration), #29 (protocol), #30 (funding). Reporting improved for items: #1, #8, #10a, #10b, #12a, #14, #17, #18, #19, #20 and #25 and declined for items #9, #21a and #27 over publication years. Limitations, reasons for caution As the consequence of our choice to adhere to the methodology of the original Cochrane review, a limitation of our study is that we excluded non-English language studies and limited the search to the previously chosen 3 databases only. Wider implications of the findings With inadequately reported diagnostic accuracy studies, the derived evidence can be misleading. Our findings represent a baseline evaluation of the reporting status of studies on blood biomarkers of endometriosis. Our results can guide researchers and editors about poorly reported STARD 2015 items, aiming to improve their future reporting quality. Trial registration number PROSPERO # CRD42021259990

Efficacy of the Cervical Vertebral Maturation Method: A Systematic Review.

The present systematic review was carried out to evaluate both qualitatively and quantitatively the effectiveness of the cervical vertebral maturation (CVM) method in predicting the pubertal growth spurt. PubMed, PMC, Scopus, SciELO, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched. The research included every article published from 1970 to June 2019, featuring the keywords: ("cervical vertebrae" OR ("cervical" AND "vertebrae") AND ("orthodontics" OR "growth and development" OR ("growth" AND "development") OR ("growth"). The Preferred Reporting Items for Reporting Systematic Reviews and Meta Analyses (PRISMA) protocol was adopted, and quality assessments modified from the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) and the "Standards for the Reporting of Diagnostic Accuracy Studies" (STARD) were performed to conduct this systematic review. Initially, 1284 articles were found. All the articles were then examined, and 43 studies met the inclusion criteria. Sixteen articles had low-quality scores, 25 had moderate scores, and 2 had high scores. The results showed a moderate to high statistically significant correlation between the CVM and other maturation methods. Overall, the CVM method can be considered an effective method and may be used with other skeletal indices for the radiographic assessment of skeletal maturity, and also to identify the growth peak in growing patients.

Association of Accuracy, Conclusions, and Reporting Completeness With Acceptance by Radiology Conferences and Journals.

Preferential publication of studies with positive findings can lead to overestimation of diagnostic test accuracy (i.e. publication bias). Understanding the contribution of the editorial process to publication bias could inform interventions to optimize the evidence guiding clinical decisions. To evaluate whether accuracy estimates, abstract conclusion positivity, and completeness of abstract reporting are associated with acceptance to radiology conferences and journals. Meta-research. Abstracts submitted to radiology conferences (European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and International Society for Magnetic Resonance in Medicine (ISMRM)) from 2008 to 2018 and manuscripts submitted to radiology journals (Radiology, Journal of Magnetic Resonance Imaging [JMRI]) from 2017 to 2018. Primary clinical studies evaluating sensitivity and specificity of a diagnostic imaging test in humans with available editorial decisions were included. Primary variables (Youden's index [YI > 0.8 vs. <0.8], abstract conclusion positivity [positive vs. neutral/negative], number of reported items on the Standards for Reporting of Diagnostic Accuracy Studies [STARD] for Abstract guideline) and confounding variables (prospective vs. retrospective/unreported, sample size, study duration, interobserver agreement assessment, subspecialty, modality) were extracted. Multivariable logistic regression to obtain adjusted odds ratio (OR) as a measure of the association between the primary variables and acceptance by radiology conferences and journals; 95% confidence intervals (CIs) and P-values were obtained; the threshold for statistical significance was P < 0.05. A total of 1000 conference abstracts (500 ESGAR and 500 ISMRM) and 1000 journal manuscripts (505 Radiology and 495 JMRI) were included. Conference abstract acceptance was not significantly associated with YI (adjusted OR=0.97 for YI > 0.8; CI=0.70-1.35), conclusion positivity (OR=1.21 for positive conclusions; CI=0.75-1.90) or STARD for Abstracts adherence (OR=0.96 per unit increase in reported items; CI=0.82-1.18). Manuscripts with positive abstract conclusions were less likely to be accepted by radiology journals (OR=0.45; CI=0.24-0.86), while YI (OR=0.85; CI=0.56-1.29) and STARD for Abstracts adherence (OR=1.06; CI=0.87-1.30) showed no significant association. Positive conclusions were present in 86.7% of submitted conference abstracts and 90.2% of journal manuscripts. Diagnostic test accuracy studies with positive findings were not preferentially accepted by the evaluated radiology conferences or journals. 3 TECHNICAL EFFICACY: Stage 2.

Delirium screening tools in the post-anaesthetic care unit: a systematic review and meta-analysis.

Delirium is a serious neurocognitive disorder among surgical patients in the post-anaesthetic care unit (PACU). Despite the development of screening tools to identify delirium, it is not clear which tool is the most accurate and reliable in assessing delirium in the PACU. To examine the diagnostic accuracy of delirium screening tools used in the PACU. A systematic literature search of CINAHL, MEDLINE, Embase, PsycINFO and Scopus was conducted, using MeSH terms and relevant keywords, from databases establishment to 23 April 2021. Studies were assessed for methodological quality using the Standards for Reporting of Diagnostic Accuracy Studies (STARD) tool. A total of 1503 studies were screened from the database search, four studies met the inclusion criteria for this review. Six delirium screening tools used in the PACU were identified in the selected studies. Three studies evaluated screening tools in adult surgical patients without cognitive impairment and dementia. Two studies evaluated screening tools among patients who were scheduled for elective surgery. Review results indicated that two tools, the 4A's test (4AT; sensitivity 96%; specificity 99%) and the 3min diagnostic interview for the Confusion Assessment Method (3D-CAM; sensitivity 100%; specificity 88%), had greatest validity and reliability as a screening tool for detecting delirium in the PACU. Results indicate the 4AT and the 3D-CAM are most accurate screening tools to detect delirium in the PACU. Further research is required to validate those tools among a broader surgical population, including patients with cognitive impairment, dementia and those undergoing emergency surgical procedures.

Preoperative Imaging in Patients with Deep Infiltrating Endometriosis: An Important Aid in Predicting Depth of Infiltration in Rectosigmoid Disease

To determine the diagnostic accuracy of specialist-performed transvaginal ultrasound (TVUS) and pelvic magnetic resonance imaging (MRI) modalities in predicting depth of deep infiltrating endometriosis (DIE) of the rectosigmoid by comparison with histologic specimens obtained at surgery. A retrospective analysis, which met the Standards for Reporting of Diagnostic Accuracy Studies (2015) guidelines for a diagnostic accuracy study. Tertiary teaching hospital. A total of 194 cases who underwent preoperative discussion at the gynecologic endosurgery unit multidisciplinary meeting between January 2012 and December 2019 were eligible for inclusion. Retrospective assessment of the accuracy of TVUS and MRI in predicting histologic depth of rectosigmoid DIE after operative management. Al total of 135 surgeries were performed for DIE; 20 underwent a rectal shave, 14 had a disc/wedge resection, 38 an anterior/segmental resection, and 63 had no rectosigmoid surgery. Of the 52 patients with full-thickness rectal wall excision, all patients had at least one imaging modality available for review; 42 (81%) had both. At least one imaging modality was in agreement with histologic depth in 48 cases (92%) (sensitivity, 94%; specificity, 50%; positive predictive value [PPV], 97.9%; negative predictive value [NPV], 25.0%; area under the receiver operating curve, 0.720; 95% confidence interval, 0.229-1.000). When TVUS was assessed in isolation, the test remained sensitive for any rectal wall involvement (sensitivity, 93.6%; specificity, 50.0%; PPV, 97.8%; NPV, 25.0%; area under the receiver operating curve, 0.718; 95% confidence interval, 0.227-1.000). When only MRI was assessed, the test demonstrated both high sensitivity and specificity for rectal wall disease (sensitivity, 86.4%; specificity, 100%; PPV, 100%; NPV, 14.2). Specialist-performed TVUS and MRI are accurate in predicting depth of disease in rectosigmoid endometriosis. These modalities were similar in their diagnostic performance at assessing depth of rectal wall involvement, and their use is justified in the preoperative planning of these gynecologic surgeries.

Artificial Intelligence for Computer Vision in Surgery: A Call for Developing Reporting Guidelines.

Artificial Intelligence for Computer Vision in Surgery: A Call for Developing Reporting Guidelines.

Developing Specific Reporting Standards in Artificial Intelligence Centred Research.

Developing Specific Reporting Standards in Artificial Intelligence Centred Research.

STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration. Translation to Russian

Diagnostic accuracy studies are, like other clinical studies, at risk of bias due to shortcomings in design and conduct, and the results of a diagnostic accuracy study may not apply to other patient groups and settings. Readers of study reports need to be informed about study design and conduct, in sufficient detail to judge the trustworthiness and applicability of the study findings. The STARD statement (Standards for Reporting of Diagnostic Accuracy Studies) was developed to improve the completeness and transparency of reports of diagnostic accuracy studies. STARD contains a list of essential items that can be used as a checklist, by authors, reviewers and other readers, to ensure that a report of a diagnostic accuracy study contains the necessary information. STARD was recently updated. All updated STARD materials, including the checklist, are available at http://www.equator-network.org/reporting-guidelines/stard. Here, we present the STARD 2015 explanation and elaboration document. Through commented examples of appropriate reporting, we clarify the rationale for each of the 30 items on the STARD 2015 checklist, and describe what is expected from authors in developing sufficiently informative study reports. This article is the reprint with Russian translation of the original that can be observed here: Cohen JF, Korevaar DA, Altman DG, et al. STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration. BMJ Open 2016;6:e012799. doi: 10.1136/bmjopen-2016-012799

Prenatal Exome Sequencing in Recurrent Fetal Structural Anomalies: Systematic Review and Meta-Analysis.

To determine the diagnostic yield of exome sequencing (ES), a microarray analysis was carried out of fetuses with recurrent fetal structural anomalies (with similar anomalies in consecutive pregnancies). This is a systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. The selected studies describing ES in fetuses with recurrent fetal malformation were assessed using the Standards for Reporting of Diagnostic Accuracy Studies (STARD) criteria for risk of bias. Incidence was used as the pooled effect size by single-proportion analysis using random-effects modeling (weighted by inverse of variance). We identified nine studies on ES diagnostic yield that included 140 fetuses with recurrent structural anomalies. A pathogenic or likely pathogenic variant was found in 57 fetuses, resulting in a 40% (95%CI: 26% to 54%) incremental performance pool of ES. As expected, the vast majority (86%: 36/42) of the newly identified diseases had a recessive inheritance pattern, and among these, 42% (15/36) of variants were found in homozygosity. Meckel syndrome was the monogenic disease most frequently found, although the genes involved were diverse. The ES diagnostic yield in pregnancies with recurrent fetal structural anomalies was 40% (57/140). Homozygous disease-causing variants were found in 36% (15/57) of the newly identified monogenic disorders.

Combination of Comorbidities as a Reference Standard for Evaluating Auditory Processing Disorder: Response to the Letter to the Editor From Schow et al. (2021).

Concerns expressed by Schow et al. (2021) around the evidence-based diagnostic criteria suggested by Ahmmed (2021a) are addressed here. The use of combination of comorbidities as a reference standard for evaluating auditory processing tests is a valid strategy, consistent with the Research Domain Criteria framework from the National Institute of Mental Health as well as the Standards for Reporting of Diagnostic Accuracy Studies. The correlations between auditory processing tests and some comorbidities in Ahmmed (2021a) were significant at p < .01. The low sensitivity and specificity reported was not related to the principle of using comorbidities as a reference standard but due to the choice of comorbidities combined in the reference standard. Ahmmed (2021a) suggested the option of inclusion of other comorbidities in addition to language impairment and impaired manual dexterity in the reference standard. Visual processing impairment could be considered as the additional comorbidity to improve sensitivity and specificity of the approach suggested by Ahmmed (2021a).

Recognition of Psychogenic Versus Epileptic Seizures Based on Videos.

Ictal semiology interpretation for differentiating psychogenic nonepileptic seizures (PNESs) and epileptic seizures (ESs) is important for the institution of appropriate treatment. Our objective was to assess the ability of different health care professionals (HCPs) or students to distinguish PNES from ES based on video-recorded seizure semiology. This study was designed following the Standards for Reporting of Diagnostic Accuracy Studies (STARD) guidelines. We showed in a random mix 36 videos of PNES or ES (18 each) and asked 558 participants to classify each seizure. The diagnostic accuracy of various groups of HCPs or students for PNES versus ES was assessed, as well as the effect of patient age and sex. Measures of diagnostic accuracy included sensitivity, specificity, and area under the curve (AUC). The descending order of diagnostic accuracy (AUC) was the following (p ≤ 0.001): (1) neurologists and epileptologists; (2) neurology residents; (3) other specialists and nurses with experience in epilepsy; and (4) undergraduate medical students. Although there was a strong trend toward statistical difference, with AUC 95% confidence intervals (CIs) that were not overlapping, between epileptologists (95% CI 93, 97) compared to neurologists (95% CI 88, 91), and neurologists compared to electroencephalography technicians (95% CI 82, 87), multiple pairwise comparisons with the conservative Tukey-Kramer honest significant difference test revealed no statistical difference (p = 0.25 and 0.1, respectively). Patient age and sex did not have an effect on diagnostic accuracy in neurology specialists. Visual recognition of PNES by HCPs or students varies overall proportionately with the level of expertise in the field of neurology/epilepsy.

Adherence to the Standards for Reporting of Diagnostic Accuracy Studies (STARD): a survey of four journals in laboratory medicine

BackgroundThe Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement has been updated in 2015. Many diagnostic test accuracy (DTA) studies have been published in medical laboratory journals, but their adherence to the updated STARD statement remains unknown.MethodsWe searched the PubMed database to verify studies published in 4 laboratory journals, including Clinical Chemistry, Clinical Chemistry and Laboratory Medicine, Clinica Chimica Acta, and Clinical Biochemistry, in 2019. DTA studies were identified and their adherence to the STARD statement was assessed.ResultsA total of 45 studies were included in this analysis. Overall, 18 out of 34 STARD items were reported. The items (adherence rate) of sample size estimation (4%), adverse events (9%), protocol (9%), registration (16%), missing value (22%), indeterminate results (18%), and cross-tabulation (22%) were the most frequently unreported items.ConclusionsAdherence to the STARD statement in DTA articles published in laboratory medicine seems as yet unsatisfactory. Our study emphasizes the necessity to improve the reporting quality of DTA studies published in medical laboratory journals.

Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) guidelines: a development protocol.

Diagnostic accuracy studies play an important role in informing clinical practice and patient management, by evaluating the ability of diagnostic testing and imaging to identify the presence or absence of a disease or condition. These studies compare the relative diagnostic strength of the test or device with a reference standard, therefore, guiding clinical decisions on the reliability of the test, the need for further tests, and whether to monitor or treat a particular condition. Inadequate and incomplete reporting of diagnostic accuracy studies can disguise methodological deficiencies and ultimately result in study bias and the inability to translate research findings into daily clinical practice. The Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) guidelines are being developed in order to improve the accuracy, transparency, completeness and reproducibility of diagnostic accuracy studies in the speciality of Endodontology. The aim of this paper is to report the process used to develop the PRIDASE guidelines based on a well-established consensus process. The project leaders (PD, VN) formed a steering committee of nine members (PD, VN, PA, AF, DR, SP, CK, MP, HD) to oversee and manage the project. The PRIDASE steering committee will develop the initial draft of the PRIDASE guidelines by adapting and modifying the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 guidelines, adding new items related specifically to the nature of Endodontics and incorporate the Clinical and Laboratory Images in Publication (CLIP) principles. The initial guidelines will consist of a series of domains and individual items and will be validated by the members of a PRIDASE Delphi Group (PDG) consisting of a minimum of 30 individuals who will evaluate independently the individual items based on two parameters: 'clarity' using a dichotomous scoring (yes/no) and 'suitability' for inclusion using a 9-point Likert Scale. The scores awarded by each member and any suggestions for improvement will be shared with the PDG to inform an iterative process that will result in a series of items that are clear and suitable for inclusion in the new PRIDASE guidelines. Once the PDG has completed its work, the steering committee will create a PRIDASE Meeting Group (PMG) of 20 individuals from around the world. Members of the PDG will be eligible to be the part of PMG. The draft guidelines and flowchart approved by the PDG will then be presented for further validation and agreement by the PMG. As a result of these discussions, the PRIDASE guidelines will be finalized and then disseminated to relevant stakeholders through publications and via the Preferred Reporting Items for study Designs in Endodontology (PRIDE) website (http://pride-endodonticguidelines.org). Periodic updates to the PRIDASE guidelines will be made based on feedback from stakeholders and end-users.