| Titre : | Consequences of different diagnostic'gold standards'in test accuracy research : Carpal Tunnel Syndrome as an example. (2005) |
| Auteurs : | Lucas-M BACHMANN ; Peter JUNI ; KESSELS (Alfons-G) : NLD. Department of Clinical Epidemiology and Medical Technology Assessment. Maastricht University Hospital. Maastricht. ; Stephan REICHENBACH ; VOGELIN (Esther) : CHE. Department of Hand Surgery. Inselspital. University of Beme. ; Hans-Rudolf ZISWILER ; Inselspital University of Berne. Department of Rheumatology and Clinical Immunology. CHE ; University of Beme. Department of Sodal and Preventive Medicine. CHE ; University of Bristol. Department of Sodal Medicine. Mrc Health Services Research Collaboration. GBR ; University of Zurich. Horten Centre. CHE |
| Type de document : | Article |
| Dans : | International journal of epidemiology (vol. 34, n° 4, 2005) |
| Pagination : | 953-955 |
| Langues: | Anglais |
| Mots-clés : | Diagnostic ; Echographie ; Norme ; Sensibilité ; Spécificité ; Système nerveux [pathologie] ; Système ostéoarticulaire [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST-CNRS R0xKFyoJ. Diffusion soumise à autorisation]. Test accuracy studies assume the existence of a well-defined illness definition and clear-cut diagnostic gold standards or reference standards. However, in clinical reality illness definitions may be vague or a mere description of a set of manifestations, mostly clinical signs and symptoms. This can lead to disagreements among experts about the correct classification of an illness and the adequate reference standard. Using data from a diagnostic accuracy study in carpal tunnel syndrome, we explored the impact of different definitions on the estimated test accuracy and found that estimated test performance characteristics varied considerably depending on the chosen reference standard. In situations without a clear-cut illness definition, randomized controlled trials may be preferable to test accuracy studies for the evaluation of a novel test. These studies do not determine the diagnostic accuracy, but the clinical impact of a novel test on patient management and outcome. |
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