Guidelines for diagnostic tests and diagnostic accuracy in surgical research.
OBJECTIVE
This is a guideline review of the application of diagnostic tests and diagnostic accuracy in surgical research.


BACKGROUND
There is an increasing use of diagnostic tests in surgery, and an understanding of the accuracy for each test is important for surgeons.


METHODS
This methodological review outlines the basic concepts of diagnostic test accuracy, including sensitivity, specificity, diagnostic odds ratio, likelihood ratios, and predictive values. Sources of bias in diagnostic accuracy studies are explained in simplified terms. The graphical methods used to present diagnostic accuracy are demonstrated. Study quality issues are outlined using published guidelines. Finally, the principles of diagnostic meta-analysis, including more advanced approaches such as bivariate and hierarchical summary receiver operating characteristic methods are explained.


CONCLUSIONS
In the era of evidence-based surgery, the ability to understand and interpret the fundamental principles of diagnostic accuracy literature is vital to improve patient care and reduce the confusion in clinical practice over the most appropriate diagnostic test.
Department of Radiology, Queen Elizabeth Hospital, Birmingham, United Kingdom.
Catherine M
CM
Jones
Hutan
H
Ashrafian
Ara
A
Darzi
Thanos
T
Athanasiou
D019540:Area Under Curve; D015982:Bias; D003951:Diagnostic Errors / Q000517:prevention & control; D003955:Diagnostic Tests, Routine / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D013502:General Surgery; D017408:Guidelines as Topic; D006801:Humans; D016013:Likelihood Functions; D015201:Meta-Analysis as Topic; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011785:Quality Assurance, Health Care; D012372:ROC Curve; D012106:Research; D012680:Sensitivity and Specificity