Deciding Whether To Complement a Systematic Review of Medical Tests With Decision Modeling
- PMID: 22834021
- Bookshelf ID: NBK98244
Deciding Whether To Complement a Systematic Review of Medical Tests With Decision Modeling
Excerpt
Limited by what is reported in the literature, most systematic reviews of medical tests focus on “test accuracy” (or better, test performance) rather than on the impact of testing on patient outcomes. The links between testing, test results, and patient outcomes are typically complex: even when testing has high accuracy, there is no guarantee that physicians will act according to tests results, that patients will follow their orders, or that the intervention will yield a beneficial endpoint. Therefore, test performance is typically not sufficient for assessing the usefulness of medical tests. Modeling (in the form of decision or economic analysis) is a natural framework for linking test performance data to clinical outcomes. We propose that (some) modeling should be considered to facilitate the interpretation of summary test performance measures by connecting testing and patient outcomes. We discuss a simple algorithm for helping systematic reviewers think through this possibility, and illustrate it by means of an example.
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References
-
- Rockville, MD: Agency for Healthcare Research and Quality; Jun, 2012. Methods Guide for Medical Test Reviews. AHRQ Publication No. 12-EC017. www.effectivehealthcare.ahrq.gov/reports/final.cfm. Also published as a special supplement to the Journal of General Internal Medicine, July 2012.
-
- Tatsioni A, Zarin DA, Aronson N, Samson DJ, Flamm CR, Schmid C, et al. Challenges in systematic reviews of diagnostic technologies. Ann Intern Med. 2005;142(12 Pt 2):1048–1055. - PubMed
-
- Trikalinos TA, Siebert U, Lau J. Decision-analytic modeling to evaluate benefits and harms of medical tests: uses and limitations. Med Decis Making. 2009;29(5):E22–E29. - PubMed
-
- Claxton K, Ginnelly L, Sculpher M, Philips Z, Palmer S. A pilot study on the use of decision theory and value of information analysis as part of the NHS Health Technology Assessment programme. Health Technol Assess. 2004;8(31):1–103. iii. - PubMed
-
- Meltzer DO, Hoomans T, Chung JW, Basu A. Minimal Modeling Approaches to Value of Information Analysis for Health Research. Rockville, MD: Agency for Healthcare Research and Quality; Jun2011. [Accessed April 10, 2012]. AHRQ Publication No 11-EHC062-EF. http://ncbi.nlm.nih.gov/books/NBK62146. - PubMed
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