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Determining qualitative effect size ratings using a likelihood ratio scatter matrix in diagnostic test accuracy systematic reviews
- Source :
- Diagnosis. 5:205-214
- Publication Year :
- 2018
- Publisher :
- Walter de Gruyter GmbH, 2018.
-
Abstract
- BackgroundDiagnostic test accuracy (DTA) systematic reviews (SRs) characterize a test’s potential for diagnostic quality and safety. However, interpreting DTA measures in the context of SRs is challenging. Further, some evidence grading methods (e.g. Centers for Disease Control and Prevention, Division of Laboratory Systems Laboratory Medicine Best Practices method) require determination of qualitative effect size ratings as a contributor to practice recommendations. This paper describes a recently developed effect size rating approach for assessing a DTA evidence base.MethodsA likelihood ratio scatter matrix will plot positive and negative likelihood ratio pairings for DTA studies. Pairings are graphed as single point estimates with confidence intervals, positioned in one of four quadrants derived from established thresholds for test clinical validity. These quadrants support defensible judgments on “substantial”, “moderate”, or “minimal” effect size ratings for each plotted study. The approach is flexible in relation to a priori determinations of the relative clinical importance of false positive and false negative test results.Results and conclusionsThis qualitative effect size rating approach was operationalized in a recent SR that assessed effectiveness of test practices for the diagnosis ofClostridium difficile. Relevance of this approach to other methods of grading evidence, and efforts to measure diagnostic quality and safety are described. Limitations of the approach arise from understanding that a diagnostic test is not an isolated element in the diagnostic process, but provides information in clinical context towards diagnostic quality and safety.
- Subjects :
- Computer science
Clinical Decision-Making
Clinical Biochemistry
Medical laboratory
Medicine (miscellaneous)
Sensitivity and Specificity
03 medical and health sciences
0302 clinical medicine
Scatter matrix
Statistics
Humans
030212 general & internal medicine
Diagnostic Errors
Grading (education)
Likelihood Functions
Operationalization
Clinical Laboratory Techniques
Clostridioides difficile
business.industry
030503 health policy & services
Health Policy
Biochemistry (medical)
Public Health, Environmental and Occupational Health
Diagnostic test
Confidence interval
Review Literature as Topic
Systematic review
Research Design
Clostridium Infections
Clinical validity
0305 other medical science
business
Subjects
Details
- ISSN :
- 2194802X and 21948011
- Volume :
- 5
- Database :
- OpenAIRE
- Journal :
- Diagnosis
- Accession number :
- edsair.doi.dedup.....7af044d18647cd86e612e89ff9bcb9aa
- Full Text :
- https://doi.org/10.1515/dx-2018-0061