Chapter 2: medical tests guidance (2) developing the topic and structuring systematic reviews of medical tests: utility of PICOTS, analytic frameworks, decision trees, and other frameworks.
Topic development and structuring a systematic review of diagnostic tests are complementary processes. The goals of a medical test review are to identify and synthesize evidence to evaluate the impacts alternative testing strategies on health outcomes and to promote informed decision making. A common challenge is that the request for a review may state the claim for the test ambiguously. Due to the indirect impact of medical tests on clinical outcomes, reviewers need to identify which intermediate outcomes link a medical test to improved clinical outcomes. In this paper, we propose the use of five principles to deal with challenges: the PICOTS typology (patient population, intervention, comparator, outcomes, timing, setting), analytic frameworks, simple decision trees, other organizing frameworks and rules for when diagnostic accuracy is sufficient.
Technology Evaluation Center, Blue Cross and Blue Shield Association, 1310 G Street NW, Washington, DC 20005, USA. David.samson@bcbsa.com
David
D
Samson
Karen M
KM
Schoelles
D000004:Abbreviations as Topic; D003661:Decision Support Techniques; D019937:Diagnostic Techniques and Procedures / Q000592:standards*; D019317:Evidence-Based Medicine / Q000379:methods / Q000592:standards; D017408:Guidelines as Topic; D006801:Humans; D012196:Review Literature as Topic