Decision making about healthcare-related tests and diagnostic test strategies. Paper 4: International guidelines show variability in their approaches.


OBJECTIVES:The objective of the study was to describe and compare current practices in developing guidelines about the use of healthcare-related tests and diagnostic strategies (HCTDS). STUDY DESIGN AND SETTING:We sampled 37 public health and clinical practice guidelines about HCTDS from various sources without language restrictions. RESULTS:Detailed descriptions of the systems used to assess the quality of evidence and develop recommendations were challenging to find within guidelines. We observed much variability among and within organizations with respect to how they develop recommendations about HCTDS. Twenty-four percent of the guidelines did not consider health benefits and harms but based decisions solely on test accuracy. We did not identify guidelines that described the main potential care pathways involving tests for a healthcare problem. In addition, we did not identify guidelines that systematically assessed, described, and referenced the evidence that linked test accuracy and patient-important outcomes. CONCLUSION:There is considerable variability among the processes used and factors considered in developing recommendations about the use of tests. This variability may be the cause for the disagreement we observed in recommendations about testing for the same condition.


J Clin Epidemiol


Mustafa RA,Wiercioch W,Arevalo-Rodriguez I,Cheung A,Prediger B,Ivanova L,Ventresca M,Brozek J,Santesso N,Bossuyt P,Garg AX,Lloyd N,Lelgemann M,Bühler D,Schünemann HJ




Has Abstract


2017-12-01 00:00:00












  • Increasing physicians' awareness of the impact of statistics on research outcomes: comparative power of the t-test and and Wilcoxon Rank-Sum test in small samples applied research.

    abstract::To effectively evaluate medical literature, practicing physicians and medical researchers must understand the impact of statistical tests on research outcomes. Applying inefficient statistics not only increases the need for resources, but more importantly increases the probability of committing a Type I or Type II err...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Bridge PD,Sawilowsky SS

    更新日期:1999-03-01 00:00:00

  • Diagnostic interpretation of electrocardiograms in population-based research: computer program research physicians, or cardiologists?

    abstract::We assessed the performance of diagnostic electrocardiogram (ECG) interpretation by the computer program MEANS and by research physicians, compared to cardiologists, in a physician-based study. To establish a strategy for ECG interpretation in health surveys, we also studied the diagnostic capacity of three scenarios:...

    journal_title:Journal of clinical epidemiology

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    authors: de Bruyne MC,Kors JA,Hoes AW,Kruijssen DA,Deckers JW,Grosfeld M,van Herpen G,Grobbee DE,van Bemmel JH

    更新日期:1997-08-01 00:00:00

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    abstract::We performed analyses to examine the structure, validity, and responsiveness to change of the Marks Asthma Quality of Life Questionnaire (AQLQ), originally validated in Australia in a self-administered format, among 539 U.S. subjects with asthma. Subjects were interviewed twice by telephone over an 18-month period. Ba...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Katz PP,Eisner MD,Henke J,Shiboski S,Yelin EH,Blanc PD

    更新日期:1999-07-01 00:00:00

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    abstract::We review methods for the analysis of categorical clinical and epidemiological data, in which the observations are subject to misclassification. Under certain conditions, it is possible to estimate error parameters such as sensitivity, specificity, relative risk, or predictive value, even though no definitive classifi...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Walter SD,Irwig LM

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  • Cluster-randomized controlled trials evaluating complex interventions in general practices are mostly ineffective: a systematic review.

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    authors: Siebenhofer A,Paulitsch MA,Pregartner G,Berghold A,Jeitler K,Muth C,Engler J

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    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Verrips GH,Stuifbergen MC,den Ouden AL,Bonsel GJ,Gemke RJ,Paneth N,Verloove-Vanhorick SP

    更新日期:2001-05-01 00:00:00

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    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,多中心研究


    authors: Amin L,Rosenbaum P,Barr R,Sung L,Klaassen RJ,Dix DB,Klassen A

    更新日期:2012-10-01 00:00:00

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    更新日期:2018-10-01 00:00:00

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    abstract::The effect of age, sex, diabetes, hypertension, pulse rate and cigarette smoking on extracranial carotid artery plaque thickness evaluated by B-mode ultrasonography was investigated in a cross-sectional study of 698 white men, 730 white women, 77 black men and 76 black women as part of a clinical ultrasound registry. ...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Tell GS,Howard G,McKinney WM

    更新日期:1989-01-01 00:00:00

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    authors: Baerlocher MO,Gautam T,Newton M,Tomlinson G

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    abstract:OBJECTIVE:The objective of this study was to examine the effectiveness of education and training interventions on recruitment to randomized and non-randomized trials. STUDY DESIGN AND SETTING:A systematic review of the effectiveness of education and training interventions for recruiters to trials. The review included ...

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    authors: Delaney H,Devane D,Hunter A,Hennessy M,Parker A,Murphy L,Cronin P,Smith V

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    authors: Sorlie PD,Cooper L,Schreiner PJ,Rosamond W,Szklo M

    更新日期:1996-07-01 00:00:00

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    authors: Bell ML,Teixeira-Pinto A,McKenzie JE,Olivier J

    更新日期:2014-05-01 00:00:00

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    abstract::In 1984, a prospective cohort study, Coronary Artery Risk Development in Young Adults (CARDIA) was initiated to investigate life-style and other factors that influence, favorably and unfavorably, the evolution of coronary heart disease risk factors during young adulthood. After a year of planning and protocol developm...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Friedman GD,Cutter GR,Donahue RP,Hughes GH,Hulley SB,Jacobs DR Jr,Liu K,Savage PJ

    更新日期:1988-01-01 00:00:00

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    journal_title:Journal of clinical epidemiology

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    authors: Chouinard E,Walter S

    更新日期:1995-02-01 00:00:00

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    authors: Wong CK,Mulhern B,Wan YF,Lam CL

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    journal_title:Journal of clinical epidemiology

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    authors: Blanco C,Rafful C,Olfson M

    更新日期:2013-08-01 00:00:00

  • Linguistic validation and reliability properties are weak investigated of most dementia-specific quality of life measurements-a systematic review.

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    authors: Dichter MN,Schwab CG,Meyer G,Bartholomeyczik S,Halek M

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    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Chuc NT,Larsson M,Do NT,Diwan VK,Tomson GB,Falkenberg T

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    authors: Moons KG,Donders RA,Stijnen T,Harrell FE Jr

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  • Cardiovascular disease in Edinburgh and north Glasgow--a tale of two cities.

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    authors: Obbarius N,Fischer F,Obbarius A,Nolte S,Liegl G,Rose M

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    journal_title:Journal of clinical epidemiology

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    authors: Diehr P,Martin DC,Koepsell T,Cheadle A,Psaty BM,Wagner EH

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    journal_title:Journal of clinical epidemiology

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    authors: Doust JA,Pietrzak E,Sanders S,Glasziou PP

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    journal_title:Journal of clinical epidemiology

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    authors: McElduff P,Attia J,Ewald B,Cockburn J,Heller R

    更新日期:2002-06-01 00:00:00

  • A likelihood-based approach to P-value interpretation provided a novel, plausible, and clinically useful research study metric.

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    journal_title:Journal of clinical epidemiology

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    authors: Adams NG,O'Reilly G

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    journal_title:Journal of clinical epidemiology

    pub_type: 临床试验,杂志文章


    authors: Gradman AH,Pangan P,Germain M

    更新日期:1989-01-01 00:00:00

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    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章


    authors: Collins GS,Reitsma JB,Altman DG,Moons KG

    更新日期:2015-02-01 00:00:00

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    authors: Kovic B,Zoratti MJ,Michalopoulos S,Silvestre C,Thorlund K,Thabane L

    更新日期:2017-08-01 00:00:00

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    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审


    authors: Greene SM,Geiger AM

    更新日期:2006-08-01 00:00:00