Development of practical recommendations for diagnostic accuracy studies in low prevalence situations.

Holtman, Gea A and Berger, Marjolein Y and Burger, Huibert and Deeks, Jonathan J and Donner-Banzhoff, Norbert and Fanshawe, Thomas R and Koshiaris, Constantinos and Leeflang, Mariska M and Oke, Jason L and Perera, Rafael and Reitsma, Johannes B and Van den Bruel, Ann (2019) Development of practical recommendations for diagnostic accuracy studies in low prevalence situations. Journal of clinical epidemiology. ISSN 1878-5921. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://www.jclinepi.com/article/S0895-4356(18)306...

Abstract

OBJECTIVE

Low disease prevalence poses challenges for diagnostic accuracy studies because of the large sample sizes that are required in order to obtain sufficient precision. The aim is to collate and discuss designs of diagnostic accuracy studies suited for use in low prevalence situations.

STUDY DESIGN AND SETTING

We conducted a literature search including backward citation tracking and expert consultation. Two reviewers independently selected studies on designs for estimating diagnostic accuracy in a low prevalence situation. During a one-day expert meeting, all designs were discussed and recommendations were formulated.

RESULTS

We identified six designs for diagnostic accuracy studies that are suitable in low prevalence situations, because they reduced the total sample size or the number of patients undergoing the index test or reference standard depending on which poses the highest burden. We described the advantages and limitations of these designs and evaluated efficiencies in sample sizes, risk of bias and alignment with the clinical pathway for applicability in routine care.

CONCLUSION

Choosing a study design for diagnostic accuracy studies in low prevalence situations should depend on whether the aim is to limit the number of patients undergoing the index test or reference standard, and the risk of bias associated with a particular design type.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WA Patients. Primary care. Medical profession. Forensic medicine
Divisions: Emergency Services > Elderly
Related URLs:
Depositing User: Mr Philip O'Reilly
Date Deposited: 10 Jun 2019 11:25
Last Modified: 10 Jun 2019 11:25
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/2151

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