scholarly journals Diagnostic test systematic reviews: Bibliographic search filters (“Clinical Queries”) for diagnostic accuracy studies perform well

2009 ◽  
Vol 62 (9) ◽  
pp. 974-981 ◽  
Author(s):  
Monika Kastner ◽  
Nancy L. Wilczynski ◽  
Ann K. McKibbon ◽  
Amit X. Garg ◽  
R. Brian Haynes
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Systematic Reviews ◽  
Search Filters ◽  
Bibliographic Search ◽  
Clinical Queries

scholarly journals Examination of the Clinical Queries and Systematic Review “hedges” in EMBASE and MEDLINE

2014 ◽  
Vol 31 (2) ◽  
pp. 27 ◽  
Author(s):  
Susan M. Bradley
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Major Error ◽  
National Library ◽  
Search Queries ◽  
Search Results ◽  
Quality Control Testing ◽  
Search Filters ◽  
The One ◽  
Clinical Queries

Introduction – This investigation sought to determine whether the methodological search filters in place as Clinical Queries limits in OvidSP EMBASE and OvidSP MEDLINE had been modified from those written by Haynes et al. and whether the translations of these in PubMed and EBSCO MEDLINE were reliable. The translated National Library of Medicine (NLM) Systematic Reviews hedges in place in OvidSP MEDLINE and EBSCO MEDLINE were also examined. Methods – Search queries were run using the Clinical Queries and Systematic Reviews hedges incorporated into OvidSP EMBASE, OvidSP MEDLINE, PubMed, and EBSCO MEDLINE to determine the reliability of these limits in comparison with the published hedge search strings. Results – Five of the OvidSP EMBASE Clinical Queries hedges produced results that were different from the published search strings. Three of the EBSCO MEDLINE and five of the PubMed translated Clinical Queries hedges yielded markedly different results (>10% difference) than those obtained using the OvidSP MEDLINE hedge counterparts. The OvidSP MEDLINE Systematic Reviews subject subset hedge was found to have a major error, which has been corrected. Discussion – Translations of hedges to appropriate syntax for other database platforms may result in significantly different search results. The platform searched should ideally be the one for which the hedges were written and tested. Regardless, the hedges in place may not be the same as the published hedge search strings. Quality control testing is needed to ensure that the hedges in place as limits are the same as those that have been published.

scholarly journals Applying the Narrow Forms of PubMed Methods-based and Topic-based Filters Increases Nephrologists’ Search Efficiency

2012 ◽  
Vol 7 (3) ◽  
pp. 95
Author(s):  
Kate Kelly
Keyword(s):  
Systematic Reviews ◽  
Citation Count ◽  
Type I ◽  
Search Performance ◽  
Clinical Question ◽  
Search Query ◽  
Search Filters ◽  
Clinical Queries ◽  
Highly Cited Articles ◽  
Highly Cited

Objective – To determine whether the use of PubMed methods-based filters and topic-based filters, alone or in combination, improves physician searching. Design – Mixed methods, survey questionnaire, comparative. Setting – Canada. Subjects – Random sample of Canadian nephrologists (n=153), responses (n=115), excluded (n=15), total (n=100). Methods – The methods are described in detail in a previously published study protocol by a subset of the authors (Shariff et al., 2010). One hundred systematic reviews on renal therapy were identified using the EvidenceUpdates service (http://plus.mcmaster.ca/EvidenceUpdates) and a clinical question was derived from each review. Randomly-selected Canadian nephrologists were randomly assigned a unique clinical question derived from the reviews and asked, by survey, to provide the search query they would use to search PubMed. The survey was administered until one valid search query for each of the one hundred questions was received. The physician search was re-executed and compared to searches where either or both methods-based and topic-based filters were applied. Nine searches for each question were conducted: the original physician search, a broad and narrow form of the clinical queries therapy filter, a broad and narrow form of the nephrology topic filter and combinations of broad and narrow forms of both filters. Significance tests of comprehensiveness (proportion of relevant articles found) and efficiency (ratio of relevant to non-relevant articles) of the filtered and unfiltered searches were conducted. The primary studies included in the systematic reviews were set as the reference standard for relevant articles. As physicians indicated they did not scan beyond two pages of default PubMed results, primary analysis was also repeated on search results restricted to the first 40 records. The ability of the filters to retrieve highly-relevant or highly-cited articles was also tested, with an article being considered highly-relevant if referenced by UpToDate and highly-cited if its citation count was greater than the median citation count of all relevant articles for that question – there was an average of eight highly-cited articles per question. To reduce the risk of type I error, the conservative method of Bonferroni was applied so that tests with a p less than 0.003 were interpreted as statistically significant. Main Results – Response rate 75%. Physician-provided search terms retrieved 46% of relevant articles and a ratio of relevant to non-relevant articles of 1:16 (p less than 0.003). Applying the narrow forms of both the nephrology and clinical queries filters together produced the greatest overall improvement, with efficiency improving by 16% and comprehensiveness remaining unchanged. Applying a narrow form of the clinical queries filter increased efficiency by 17% (p less than 0.003) but decreased comprehensiveness by 8% (p less than 0.003). No combination of search filters produced improvements in both comprehensiveness and efficiency. When results were restricted to the first 40 citations, the use of the narrow form of the clinical queries filter alone improved overall search performance – comprehensiveness improved from 13% to 26 % and efficiency from 5.5% to 23%. For highly-cited or highly-relevant articles the combined use of the narrow forms of both filters produced the greatest overall improvement in efficiency but no significant change in comprehensiveness. Conclusion – The use of PubMed search filters improves the efficiency of physician searches and saves time and frustration. Applying clinical filters for quick clinical searches can significantly improve the efficiency of physician searching. Improved search performance has the potential to enhance the transfer of research into practice and improve patient care.

scholarly journals Role and utility of COVID-19 laboratory testing in low-income and middle-income countries: protocol for rapid evidence synthesis

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e050296
Author(s):  
Ojiambo Kevin Ouma ◽  
Kisangala Ephraim ◽  
Nakalembe Loyce ◽  
Eve Namisango ◽  
Fred Nalugoda ◽  
...  
Keyword(s):  
Laboratory Test ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Systematic Reviews ◽  
Low Income ◽  
Laboratory Testing ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Middle Income ◽  
Middle Income Countries

IntroductionAccurate and affordable laboratory testing is key to timely diagnosis and appropriate management of patients with COVID-19. New laboratory test protocols are released into the market under emergency use authorisation with limited evidence on diagnostic test accuracy. As such, robust evidence on the diagnostic accuracy and the costs of available tests is urgently needed to inform policy and practice especially in resource-limited settings. We aim to determine the diagnostic test accuracy, cost-effectiveness and utility of laboratory test strategies for COVID-19 in low-income and middle-income countries.Methods and analysisThis will be a multistaged, protocol-driven systematic review conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for diagnostic test accuracy studies. We will search for relevant literature in at least six public health databases, including PubMed, Google Scholar, MEDLINE, Scopus, Web of Science and the WHO Global Index Medicus. In addition, we will search Cochrane Library, COVID-END and grey literature databases to identify additional relevant articles before double-screening and abstraction of data. We will conduct a structured narrative and quantitative synthesis of the results guided by the Fryback and Thornbury framework for assessing a diagnostic test. The primary outcome is COVID-19 diagnostic test accuracy. Using the GRADE approach specific to diagnostic accuracy tests, we will appraise the overall quality of evidence and report the results following the original PRISMA statement. The protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO; https://www.crd.york.ac.uk/prospero/).Ethics and disseminationEthical review was done by the School of Biomedical Sciences Research Ethics Committee and the Uganda National Council for Science and Technology. The published article will be accessible to policy and decision makers. The findings of this review will guide clinical practice and policy decisions and highlight areas for future research.PROSPERO registration number CRD42020209528.

scholarly journals Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 7: Systematic Reviews and Meta-Analyses of Diagnostic Accuracy Studies

2009 ◽  
Vol 6;12 (6;12) ◽  
pp. 929-963
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Health Care ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Diagnostic Techniques ◽  
Evidence Based ◽  
Health Care Decisions ◽  
Interventional Pain Management ◽  
Based Medicine

Appropriate diagnosis is essential in providing proper and effective therapy. The field of diagnostic accuracy tests is dynamic with new tests being developed at a fast pace along with improvement in technology of existing tests on a continuous basis. Welldesigned diagnostic test accuracy studies can help in making appropriate health care decisions, provided that they transparently and fully report their participants, tests, methods, and results. Exaggerated and biased results from poorly designed and reported diagnostic test studies can trigger their premature dissemination and lead physicians into making incorrect treatment decisions. Consequently, a diagnostic test is useful only to the extent that it distinguishes between conditions or disorders that might otherwise be confused. Since it is unlikely that clinicians, patients, and policy makers have the time, skills, and resources to find, appraise, and interpret the evidence and incorporate it into their health care decisions, systematic reviews and meta-analysis provide an accurate and reliable synthesis of vast quantities of data. A systematic review can identify what is known and what is unknown, giving guidance for future research. Systematic reviews have been considered as a vital link in the great chain of evidence that stretches from the laboratory to the bedside by helping to separate the insignificant, unsound, or redundant deadwood from the salient and critical studies that are worthy of reflection. A dangerous discrepancy exists between experts and evidence with all types of evidence. Historically, it has been reported that in only 15% of all cases can a pathoanatomical explanation be found for patients with chronic low back pain of more than 3 months resulting in the assumption that very little can be done in our present state of ignorance to treat these patients and improve their natural histories. On the other end of the spectrum, due to lack of sound diagnostic information, excessive health care is utilized with exploding costs. The validity of all diagnostic techniques has been described with variable accuracy and reliability. Lack of understanding of reference standards and their unavailability with interventional diagnostic techniques and misinterpretation secondary to interpretation bias may adversely influence the applicability of diagnostic interventions. This manuscript provides a review of the literature, a checklist, and a flow diagram describing the preferred way to present the abstract, introduction, methods, results, and discussion sections of the report of an analysis in a systematic review of diagnostic accuracy studies. Key words: Diagnostic accuracy studies, evidence-based medicine, systematic reviews, meta-analysis, comparative effectiveness studies, interventional pain management, Standards for the Reporting of Diagnostic Accuracy Studies (STARD)

scholarly journals Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 5. Diagnostic Accuracy Studies

2009 ◽  
Vol 3;12 (3;5) ◽  
pp. 517-540
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Pain Management ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Diagnostic Tests ◽  
Evidence Based ◽  
Interventional Techniques ◽  
Interventional Pain Management ◽  
Based Medicine

Diagnosis is a critical component of health care. The world of diagnostic tests is highly dynamic. New tests are developed at a fast pace and technology of existing tests is continuously being improved. However, clinicians, policy makers, and patients routinely face a range of questions regarding diagnostic tests. Well designed diagnostic test accuracy studies can help in making these decisions, provided that they transparently and fully report their participants, tests, methods, and results (as facilitated). For example, by the standards for the reporting of diagnostic accuracy studies (STARD) statement. Exaggerated and biased results from poorly designed and reported diagnostic test studies can trigger their premature dissemination and lead physicians into making incorrect treatment decisions. Thus, a diagnostic test is useful only to the extent that it distinguishes between conditions or disorders that might otherwise be confused. While almost any test can differentiate healthy persons from severely affected ones, appropriate diagnostic tests should differentiate mild and moderate forms of disease. Shortcomings in a study design and interpretation can affect estimates of diagnostic accuracy. Thus, quality diagnostic studies are essential in medicine in general and interventional pain management in particular. The STARD initiative was developed to improve the accuracy and completeness in the reporting of studies of diagnostic accuracy and provide guidance to assist in reducing the potential for bias in the study and to evaluate a study’s generalizability. In the practice of interventional pain management, in addition to diagnostic tests which include laboratory tests, imaging tests, and physical examination, diagnostic interventional techniques are crucial. Interventional techniques as a diagnostic tool in painful conditions is important due to multiple challenging clinical situations, which include the purely subjective nature of pain and underdetermined and uncertain pathophysiology in most painful spinal conditions. Precision diagnostic blocks are used to clarify these challenging clinical situations in order to determine the pathophysiology of clinical pain, the site of nociception, and the pathway of afferent neural signals. Part 5 of evidence-based medicine (EBM) in interventional pain management describes the various aspects of diagnostic accuracy studies. Key words: Evidence-based medicine, diagnostic studies, systematic reviews, randomized trials, interventional pain management, standards for the reporting of diagnostic accuracy studies (STARD)

scholarly journals Systematic Reviews of Studies Quantifying the Accuracy of Diagnostic Tests and Markers

2012 ◽  
Vol 58 (11) ◽  
pp. 1534-1545 ◽  
Author(s):  
Johannes B Reitsma ◽  
Karel GM Moons ◽  
Patrick MM Bossuyt ◽  
Kristian Linnet
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Systematic Reviews ◽  
Diagnostic Tests ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Recent Developments ◽  
Potential Benefits ◽  
Made In

Abstract Systematic reviews of diagnostic accuracy studies allow calculation of pooled estimates of accuracy with increased precision and examination of differences in accuracy between tests or subgroups of studies. Recently, several advances have been made in the methods used in performing systematic reviews of diagnostic test accuracy studies, most notably in how to assess the methodological quality of primary diagnostic test accuracy studies by use of QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) instrument and how to develop sound statistical models for metaanalysis of the paired measures of test accuracy (bivariate metaregression model of sensitivity and specificity). This article provides an overview of the different steps within a diagnostic systematic review and highlights these advances, illustrated with empirical data. The potential benefits of some recent developments in the areas of network metaanalysis and individual patient data metaanalysis for diagnostic tests are also discussed.

scholarly journals Systematic review protocol to assess artificial intelligence diagnostic accuracy performance in detecting acute ischaemic stroke and large-vessel occlusions on CT and MR medical imaging

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043665
Author(s):  
Srinivasa Rao Kundeti ◽  
Manikanda Krishnan Vaidyanathan ◽  
Bharath Shivashankar ◽  
Sankar Prasad Gorthi
Keyword(s):  
Artificial Intelligence ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Ischaemic Stroke ◽  
Study Protocol ◽  
Systematic Reviews ◽  
Acute Ischaemic Stroke ◽  
Meta Analysis ◽  
Large Vessel ◽  
Sufficient Data

IntroductionThe use of artificial intelligence (AI) to support the diagnosis of acute ischaemic stroke (AIS) could improve patient outcomes and facilitate accurate tissue and vessel assessment. However, the evidence in published AI studies is inadequate and difficult to interpret which reduces the accountability of the diagnostic results in clinical settings. This study protocol describes a rigorous systematic review of the accuracy of AI in the diagnosis of AIS and detection of large-vessel occlusions (LVOs).Methods and analysisWe will perform a systematic review and meta-analysis of the performance of AI models for diagnosing AIS and detecting LVOs. We will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-analyses Protocols guidelines. Literature searches will be conducted in eight databases. For data screening and extraction, two reviewers will use a modified Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist. We will assess the included studies using the Quality Assessment of Diagnostic Accuracy Studies guidelines. We will conduct a meta-analysis if sufficient data are available. We will use hierarchical summary receiver operating characteristic curves to estimate the summary operating points, including the pooled sensitivity and specificity, with 95% CIs, if pooling is appropriate. Furthermore, if sufficient data are available, we will use Grading of Recommendations, Assessment, Development and Evaluations profiler software to summarise the main findings of the systematic review, as a summary of results.Ethics and disseminationThere are no ethical considerations associated with this study protocol, as the systematic review focuses on the examination of secondary data. The systematic review results will be used to report on the accuracy, completeness and standard procedures of the included studies. We will disseminate our findings by publishing our analysis in a peer-reviewed journal and, if required, we will communicate with the stakeholders of the studies and bibliographic databases.PROSPERO registration numberCRD42020179652.

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