Challenges and opportunities in evaluating diagnostic tests.

The field of clinical research conducted to evaluate diagnostic tests has evolved substantially over the last 25 years. This article discusses three current challenges and opportunities in conducting such research: the limitations of the "traditional focus" of clinical epidemiology in evaluating tests; how different decision makers use data produced by clinical epidemiology research, and what those uses mean for future research; and special challenges and opportunities in evaluating molecular-based tests.

[1]  A R Feinstein,et al.  Use of methodological standards in diagnostic test research. Getting better but still not good. , 1995, JAMA.

[2]  Lisa M. Schwartz,et al.  The Role of Numeracy in Understanding the Benefit of Screening Mammography , 1997, Annals of Internal Medicine.

[3]  D. Ransohoff.  Research opportunity at the interface of molecular biology and clinical epidemiology , 2002 .

[4]  A R Feinstein,et al.  XXXI. On the sensitivity, specificity, and discrimination of diagnostic tests , 1975, Clinical pharmacology and therapeutics.

[5]  Charles M. Perou,et al.  Tumor classification using gene expression patterns from DNA microarrays , 2000 .

[6]  Floyd J Fowler,et al.  Why is prostate cancer screening so common when the evidence is so uncertain? A system without negative feedback. , 2002, The American journal of medicine.

[7]  A R Feinstein,et al.  Misguided efforts and future challenges for research on “diagnostic tests” , 2002, Journal of epidemiology and community health.

[8]  G. Guyatt,et al.  Users' Guides to the Medical Literature: III. How to Use an Article About a Diagnostic Test: B. What Are the Results and Will They Help Me In Caring for My Patients? , 1994 .

[9]  A. Feinstein,et al.  Problems of spectrum and bias in evaluating the efficacy of diagnostic tests. , 1978, The New England journal of medicine.

[10]  H C Sox,et al.  Preventive health services in adults. , 1994, The New England journal of medicine.

[11]  David Sidransky,et al.  Emerging molecular markers of cancer , 2002, Nature Reviews Cancer.

[12]  C. Mulrow,et al.  Current methods of the US Preventive Services Task Force: a review of the process. , 2001, American journal of preventive medicine.

[13]  D A Redelmeier,et al.  Understanding patients' decisions. Cognitive and emotional perspectives. , 1993, JAMA.

[14]  A. Feinstein,et al.  How to evaluate a diagnostic marker test. Lessons from the rise and fall of dexamethasone suppression test. , 1988, JAMA.

[15]  D A Redelmeier,et al.  Discrepancy between medical decisions for individual patients and for groups. , 1990, The New England journal of medicine.

[16]  CONTROVERSY IN THE DETECTION OF DISEASE , 1975, The Lancet.

[17]  A R Feinstein,et al.  Clinical epidemiological quality in molecular genetic research: the need for methodological standards. , 1999, JAMA.

[18]  A. Feinstein,et al.  Spectrum Bias in the Evaluation of Diagnostic Tests: Lessons from the Rapid Dipstick Test for Urinary Tract Infection , 1992, Annals of Internal Medicine.

[19]  G. Guyatt,et al.  Users' guides to the medical literature. III. How to use an article about a diagnostic test. B. What are the results and will they help me in caring for my patients? The Evidence-Based Medicine Working Group. , 1994, JAMA.

[20]  Frederick Mosteller,et al.  Guidelines for Meta-analyses Evaluating Diagnostic Tests , 1994, Annals of Internal Medicine.