Assessing the Imaging Literature: Understanding Error and Bias

  • C. Craig Blackmore
  • L. Santiago Medina
  • James G. Ravenel
  • Gerard A. Silvestri
  • Kimberly E. Applegate
Reference work entry
Part of the Evidence-Based Imaging book series (Evidence-Based Imag.)


The keystone of the evidence-based imaging (EBI) approach is to critically assess the research data that are provided and to determine if the information is appropriate for use in answering the EBI question. Unfortunately, the published studies are often limited by bias, small sample size, and methodological inadequacy. Further, the information provided in published reports may be insufficient to allow estimation of the quality of the research. Two recent initiatives, the CONSORT [1] and the STARD [2], aim to improve the reporting of clinical trials and studies of diagnostic accuracy, respectively. However, these guidelines are only now being implemented and are not well known to readers of the medical literature.


Carotid Artery Disease Imaging Literature Standard Bias Spectrum Bias Methodological Inadequacy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Moher D, Schulz K, Altman D. J Am Med Assoc. 2001;285:1987–91.CrossRefGoogle Scholar
  2. 2.
    Bossuyt PM, Reitsma J, Bruns D, et al. Acad Radiol. 2003;10:664–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Hulley SB, Cummings SR. Designing clinical research. Baltimore: Williams and Wilkins; 1998.Google Scholar
  4. 4.
    Medina L, Zurakowski D. Radiology. 2003;226:297–301.PubMedCrossRefGoogle Scholar
  5. 5.
    Gallagher E. Acad Emerg Med. 1999;6:1084–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Lang T, Secic M. How to report statistics in medicine. Philadelphia: American College of Physicians; 1997.Google Scholar
  7. 7.
    Gardener M, Altman D. Br Med J. 1986;292:746–50.CrossRefGoogle Scholar
  8. 8.
    Medina L, Aguirre E, Zurakowski D. Neuroimaging Clin N Am. 2003;13:157–65.PubMedCrossRefGoogle Scholar
  9. 9.
    Medina L. AJNR Am J Neuroradiol. 1999;20:1584–96.PubMedGoogle Scholar
  10. 10.
    Donner A. Stat Med. 1984;3:199–214.PubMedCrossRefGoogle Scholar
  11. 11.
    Maclure M, Schneeweiss S. Epidemiology. 2001;12:114–22.PubMedCrossRefGoogle Scholar
  12. 12.
    Reid MC, Lachs MS, Feinstein AR. J Am Med Assoc. 1995;274:645–51.CrossRefGoogle Scholar
  13. 13.
    Lijmer JG, Mol BW, Heisterkamp S, et al. J Am Med Assoc. 1999;282:1061–6.CrossRefGoogle Scholar
  14. 14.
    Blackmore C. Acad Radiol. 2004;11:134–40.PubMedCrossRefGoogle Scholar
  15. 15.
    Ransohoff DF, Feinstein AR. N Engl J Med. 1978;299:926–30.PubMedCrossRefGoogle Scholar
  16. 16.
    Black WC. AJR Am J Roentgenol. 1990;154:17–22.PubMedCrossRefGoogle Scholar
  17. 17.
    Begg CB, McNeil BJ. Radiology. 1988;167:565–9.PubMedGoogle Scholar
  18. 18.
    Schulz K, Chalmers I, Hayes R, Altman D. J Am Med Assoc. 1995;273:408–12.CrossRefGoogle Scholar
  19. 19.
    Terasawa T, Blackmore C, Bent S, Kohlwes R. Ann Intern Med. 2004;141:537–46.PubMedCrossRefGoogle Scholar
  20. 20.
    Marcus P. Lung Cancer. 2003;41:37–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Hosek R, Flanders W, Sasco A. Am J Epidemiol. 1996;143:193–201.PubMedCrossRefGoogle Scholar
  22. 22.
    Patz E, Goodman P, Bepler G. N Engl J Med. 2000;343:1627–33.PubMedCrossRefGoogle Scholar
  23. 23.
    Black WC, Welch HG. AJR Am J Roentgenol. 1997;168:3–11.PubMedCrossRefGoogle Scholar
  24. 24.
    Black W, Haggstrom D, Welch H. J Natl Cancer Inst. 2002;94:167–73.PubMedCrossRefGoogle Scholar
  25. 25.
    Kent DL, Haynor DR, Longstreth Jr WT, Larson EB. Ann Intern Med. 1994;120:856–71.PubMedCrossRefGoogle Scholar
  26. 26.
    Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HC. Radiology. 2003;226(1):24–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Whiting P, Rutjes A, Reitsma J, Bossuyt P, Kleijnen J. BMC Med Res Methodol. 2003;3:25.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • C. Craig Blackmore
    • 1
  • L. Santiago Medina
    • 2
    • 5
    • 6
  • James G. Ravenel
    • 3
  • Gerard A. Silvestri
    • 3
  • Kimberly E. Applegate
    • 4
  1. 1.Department of RadiologyVirginia Mason Medical CenterSeattleUSA
  2. 2.Division of Neuroradiology-Neuroimaging, Department of RadiologyMiami Children’s HospitalMiamiUSA
  3. 3.Department of MedicineMedical University of South CaroclinaCharlestonUSA
  4. 4.Department of Radiology and Imaging SciencesEmory University School of MedicineAtlantaUSA
  5. 5.Herbert Wertheim College of MedicineFlorida International UniversityMiamiUSA
  6. 6.Former Lecturer in RadiologyHarvard Medical SchoolBostonUSA

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