Please reply to: Merrick Zwarenstein <[log in to unmask]>
>Organization: Medical Research Council
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>To: Trisha Greenhalgh <[log in to unmask]>
>Subject: Re: Validating diagnostic tests in the absence of an established
gold
> standard
>
>
>Merrick Zwarenstein wrote:
>>
>> Dear List Members,
>>
>> For patients the issue is whether being tested improves their health
>> outcome. Of course testing itself is not directly therapeutic, so taking
>> this path places the test in the context of particular health system,
>> practitioner and patient practices. But if a test doesnt result in
>> improved health, why do it?
>>
>> In this exampke, we tested the gold standard, chest xray, against
>> clinical diagnosis, and found no added benefit. there has been
>> remarkably little response to the paper. Possibly because this approach
>> to assessing diagnostic value is relatively unusual?
>>
>> Reference:
>> Randomised controlled trial of clinical outcome after chest radiograph
>> in ambulatory acute lower-respiratory infection in children.
>> Lancet. 1998 Feb 7;351(9100):404-8.
>
>Merrick Zwarenstein,
>Health Systems Research
>South African Medical Research Council
>Attachment Converted: "G:\Attachments\merrick.zwarenstein.vcf"
>
Dr Trish Greenhalgh
Senior lecturer in primary health care
Unit for Evidence-Based Practice and Policy
Royal Free & University College Medical School
Department of Primary Care & Population Sciences
Archway Resource Centre
Holborn Union Building
Highgate Hill
London N19 3UA
Personal Assistant and Unit Administrator (Marcia Rigby): + 44 (0) 171 288
3246
Fax: + 44 (0) 171 281 8004
email [log in to unmask]
Websites
Unit for Evidence Based Practice:
http://www.ucl.ac.uk/primcare-popsci/uebpp/uebpp.htm
MSc in primary care: http://www.ucl.ac.uk/primcare-popsci/msc/index.html
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