Original articleThe role of before-after studies of therapeutic impact in the evaluation of diagnostic technologies
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2022, Journal of DentistryCitation Excerpt :Validated tools for the assessment of therapeutic efficacy studies are limited [10]. Potential bias in the studies were examined based on Guyatt's critique [13]. Risk of bias assessment was performed using a modification of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool [14] (Appendix Table 2).
Randomised Controlled Trials Assessing the Clinical Value of Urodynamic Studies: A Systematic Review and Meta-analysis
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2022, Clinical RadiologyCitation Excerpt :This was appropriate because the review confirmed there were many low-quality studies describing heterogeneous results that were mostly poorly reported. Studies with and without a comparison group were included to present all published data, but there were few studies without significant risk of bias from which to draw strong conclusions about the impact of EUS on recurrence and survival rates.67 Lastly, publication bias could not be evaluated, but it was assumed that the estimates of effect size reported here are likely to be at the higher end of those observed in routine clinical practice.
Decision making about healthcare-related tests and diagnostic test strategies. Paper 2: a review of methodological and practical challenges
2017, Journal of Clinical EpidemiologyCitation Excerpt :This design is mainly appropriate for measuring the added accuracy or efficacy of an add-on test [35]. The main criticism of this design is that clinicians’ reported plans during a research study may differ from their decision-making in an actual scenario, and so implementation of the test may not produce the same results achieved in RCTs [36]. Some investigators use case–control study designs in an attempt to determine accuracy of a test.
Systematic survey of randomized trials evaluating the impact of alternative diagnostic strategies on patient-important outcomes
2017, Journal of Clinical EpidemiologyCitation Excerpt :This hierarchy implies that smaller subsets of patients will benefit from a test as researchers advance from simply measuring diagnostic accuracy to evaluating improvements in outcomes (Appendix Fig. 1 on the journal's Web site at www.elsevier.com) [9]. When, despite demonstration of test accuracy, patient benefit remains in doubt, randomized clinical trials (RCTs) that address the impact of alternative diagnostic strategies on patient-important outcomes are required [6–8,10–12]. This principle is well established for screening tests, and investigators have conducted many trials of screening tests.
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Dr Guyatt is a Career Scientist of the Ontario Ministry of Health.