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You should be aware of the Fryback and Thornbury hierarchy of diagnostic efficacy (Fryback, DG and Thornbury, JR, The efficacy of diagnostic imaging, Med Decis Making 1991, 11:88-94). Interestingly, the typical sensitivity/specificity or PPV/NPV studies are at a very low level in this hierarchy. Above these come the ability of the test to change diagnostic thinking, the ability to change therapeutic practice, patient efficacy (ability to improve disease measures and/or quality of life measures), and the top level is cost-benefit studies from the societal perspective. This top level is important because essentially all diagnostic test issues devolve into cost-effectiveness questions. David L. Doggett, Ph.D. Senior Medical Research Analyst Technology Assessment Group ECRI, a non-profit health services research organization 5200 Butler Pike Plymouth Meeting, PA 19462-1298, USA Phone: +1 (610) 825-6000 ext.5509 Fax: +1(610) 834-1275 E-mail: [log in to unmask] > -----Original Message----- > From: Nino Cartabellotta [SMTP:[log in to unmask]] > Sent: Friday, March 31, 2000 10:10 AM > To: Farquhar, Cynthia > Cc: [log in to unmask] > Subject: Re: Levels of evidence and guideline recommendations for > diagnostic tests > > At 09.54 31/03/00 -0500, you wrote: > >Dear All, > > > >I am writing to enquire if any one know of a system for grading evidence > >and making guideline recommendations for comparative tests for > diagnostics. > >Most of the systems that I have seen have really only referred to MA, > >systematic reviews and RCTS for therapeutics. > > You can find it at: > http://cebm.jr2.ox.ac.uk/eboc/eboclevels.html > > Bests > Dott. Nino Cartabellotta > 0339 6443819 > [log in to unmask] > > -------------------------------------------------------------------------- > ---- > G I M B E > Gruppo Italiano per la Medicina Basata sulle Evidenze > -------------------------------------------------------------------------- > ---- > Passaggio L. da Vinci, 16 - 90145 Palermo > Telefax 091 407153 > [log in to unmask] > -------------------------------------------------------------------------- > ---- > www.gimbe.org > -------------------------------------------------------------------------- > ---- %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%