How to interpret randomised trials of test-treatment combinations: a critical evaluation of research on uterine Doppler test to predict, and aspirin to prevent, pre-eclampsia.
The methodology to evaluate either a test or treatment is well developed and understood. However, the design, conduct and interpretation of a combination of a test and a treatment in a single study are fraught with complexities. There are two distinct study designs to evaluate test-treatment combinations, with randomisation occurring either before or after the test. We present critical issues that need to be considered when evaluating and appraising test-treatment combinations, using the example of research on the uterine artery Doppler test to predict, and aspirin to prevent, pre-eclampsia.
Fox
C
C
University of Birmingham, Edgbaston, Birmingham, UK.
Khan
K S
KS
Coomarasamy
A
A
D001241:Aspirin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015588:Observer Variation; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011225:Pre-Eclampsia / Q000503:physiopathology / Q000517:prevention & control*; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler / Q000592:standards*; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000502:physiology*
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin