Grading evidence from test accuracy studies: what makes it challenging compared with the grading of effectiveness studies?

Ewelina Rogozińska, Khalid Khan
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引用次数: 3

Abstract

Guideline panels need to process a sizeable amount of information to issue a decision on whether to recommend a health technology or not. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) is being frequently applied in guideline development to facilitate this task, typically for the synthesis of effectiveness research. Questions regarding the accuracy of medical tests are ubiquitous, and they temporally precede questions about therapy. However, literature summarising the experience of applying GRADE approach to accuracy evaluations is not as rich as one for effectiveness evidence. Type of study design (cross-sectional), two-dimensional nature of the performance measures (sensitivity and specificity), propensity towards a higher level of between-study heterogeneity, poor reporting of quality features and uncertainty about how best to assess for publication bias among other features make this task challenging. This article presents solutions adopted to addresses above challenges for judicious estimation of the strength of test accuracy evidence used to inform evidence syntheses for guideline development.

测试准确性研究的证据分级:与有效性研究的分级相比,是什么使其具有挑战性?
准则小组需要处理大量信息,才能就是否推荐一种卫生技术作出决定。评价、发展和评价(GRADE)在指南制定中经常被应用,以促进这项任务,通常用于综合有效性研究。关于医学测试的准确性的问题无处不在,它们暂时先于关于治疗的问题。然而,总结应用GRADE方法进行准确性评估的经验的文献并不像有效性证据那样丰富。研究设计类型(横断面)、性能测量的二维性质(敏感性和特异性)、研究间异质性倾向较高、质量特征报告不足以及如何最好地评估其他特征中的发表偏倚的不确定性使这项任务具有挑战性。本文提出了解决上述挑战的解决方案,以明智地估计用于指导指南制定的证据综合的测试准确性证据的强度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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