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Hultcrantz, Monica, Mustafa, Reem A, Leeflang, Mariska M G, Lavergne, Valéry, Estrada-Orozco, Kelly, Ansari, Mohammed T, Izcovich, Ariel, Singh, Jasvinder, Chong, Lee Yee, Rutjes, Anne, Steingart, Karen, Stein, Airton, Sekercioglu, Nigar, Rodriguez, Ingrid Arévalo, Morgan, Rebecca L, Guyatt, Gordon, Bossuyt, Patrick, Langendam, Miranda W and Schünemann, Holger J (2020) 'Defining ranges for certainty ratings of diagnostic accuracy: A GRADE concept paper.'. Journal of Clinical Epidemiology, Vol 117, pp. 138-148.
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Abstract
OBJECTIVE
To clarify how the Grading of Recommendations Assessment, Development and Evaluation (GRADE) concept of certainty of evidence applies to certainty ratings of test accuracy.
STUDY DESIGN AND SETTING
After initial brainstorming with GRADE Working Group members, we iteratively refined and clarified the approaches for defining ranges when assessing the certainty of evidence for test accuracy within a systematic review, health technology assessment, or guidelines.
RESULTS
Ranges can be defined both for single test accuracy and for comparative accuracy of multiple tests. For systematics reviews and health technology assessments, approaches for defining ranges include some that do not require value judgments regarding downstream health outcomes. Key challenges arise in the context of a guideline that requires ranges for sensitivity and specificity that are set considering possible effects on all critical outcomes. We illustrate possible approaches and provide an example from a systematic review of a direct comparison between two test strategies.
CONCLUSIONS
This GRADE concept paper provides a framework for assessing, presenting, and making decisions based on the certainty of evidence for test accuracy. More empirical research is needed to support future GRADE guidance on how to best operationalize the candidate approaches.
| Item Type: | Article |
|---|---|
| Subjects: | W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84.4 Quality of Health Care |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1016/j.jclinepi.2019.05.002 |
| Depositing User: | Stacy Murtagh |
| Date Deposited: | 22 May 2019 11:27 |
| Last Modified: | 18 May 2020 01:02 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/10799 |
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