Evidence-based medicine (EBM) or practice integrates the best research evidence with clinical experience and client values. A systematic review (SR) uses explicit and transparent methods to identify, select, appraise, and synthesize results from different, but related, studies. Diagnostic tests are used to aid health professionals in the diagnosis or detection of a specific health outcome. They provide information related to the current stage of the condition, considering the clinical context, to help professionals make decisions.
What differentiates an SR from a narrative review is an established and documented protocol that aims to be replicable and avoids or minimizes the risk of bias or aleatory effects. In this context, the design of the protocol, which is one of the crucial steps in developing an SR, should outline the research question, eligibility criteria, and methods that the authors are going to use. A diagnostic test accuracy review has specific features that include, in addition to health outcomes, descriptions of the index and reference tests, results, and accuracy estimates. A diagnostic test accuracy review explores the accuracy of an index test in discriminating between people who currently present the health condition from people without it. This chapter presents the main concepts in developing a protocol for an SR of diagnostic test accuracy to assist healthcare professionals.
KeywordsProtocol Systematic review Meta-analysis Diagnostic test Accuracy Index test Reference test Decision-making Evidence-based medicine
- 1.Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Edinburgh: Churchill Livingstone; 2000.Google Scholar
- 4.MMG L. Systematic reviews and meta-analyses of diagnostic test accuracy. Clin. Microbiol. Infect. 2013;20:105–13.Google Scholar
- 5.Diretrizes Metodológicas: Elaboração de Revisão Sistemática e Metanálise de Estudos de Acurácia Diagnóstica [Internet]. Ministério. Brasília, DF: Ministério da Saúde, Secretaria de Ciência, Tenologia e Insumos Estratégicos, Departamento de Ciência e Tecnologia; 2014. http://bvsms.saude.gov.br/bvs/ct/PDF/diretrizes_metodologicas_revisao_sistematica_metanalise_de_estudos.pdf. Accessed 28 June 2018.
- 6.Centre for Reviews and Dissemination. Systematic reviews: CRD’s guidance for undertaking reviews in healthcare. Centre for Reviews and Dissemination, editor. Centre for Reviews and Dissemination; 2009.Google Scholar
- 7.Deeks JJ, Wisniewski S, Davenport C. Chapter 4: guide to the contents of a Cochrane diagnostic test accuracy protocol. In: Deeks JJ, Bossuyt PM, Gatsonis C, editors. Cochrane handbook systematic reviews of diagnostic test accuracy version 1.0.0: The Cochrane Collaboration; 2013. p. 1–15. srdta.cochrane.org. Accessed 28 June 2018.
- 9.Campbell JM, Klugar M, Ding S, Carmody DP, Hakonsen SJ, Jadotte YT, White S, Munn Z. Chapter 9: diagnostic test accuracy systematic reviews. In: Aromataris E, Munn Z, editors. The systematic review of studies of diagnostic test accuracy. Adelaide, SA, Australia: The Joanna Briggs Institute Reviewers’ Manual; 2015.Google Scholar
- 12.Deeks JJ, Takwoingi Y, Leeflang MM, Davenport C. Use of medical tests. Lesson 1.1: Cochrane collaboration DTA online learning materials. The Cochrane Collaboration. 2014.Google Scholar
- 13.Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Paul P, Irwig L, et al. Research methods & reporting STARD 2015: an updated list of essential items for. BMJ. 2015;5527:1–9.Google Scholar