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Robert Harper, Barnaby Reeves; Compliance with Methodological Standards When Evaluating Ophthalmic Diagnostic Tests. Invest. Ophthalmol. Vis. Sci. 1999;40(8):1650-1657.
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purpose. To draw attention to the importance of methodological standards when
carrying out evaluations of ophthalmic diagnostic tests by reviewing
the extent of compliance with these standards in reports of evaluations
published within the ophthalmic literature.
methods. Twenty published evaluations of ophthalmic screening/diagnostic tests
or technologies were independently assessed by two reviewers for
compliance with the following methodological standards: specification
of the spectrum composition for populations used in the evaluation,
analysis of pertinent subgroups, avoidance of work-up (verification)
bias, avoidance of review bias, presentation of precision of results
for test accuracy, presentation of indeterminate test results, and
presentation of test reproducibility.
results. Compliance ranged from just 10% (95% CI, 1%–32%) for presentation
of test reproducibility data and avoidance of review bias to 70% (95%
CI, 46%–88%) for avoidance of work-up bias and presentation of
indeterminate test results. Only 5 of the 20 evaluations complied with
four or more of the methodological standards and none with more than
five of the standards.
conclusions. The evaluations of ophthalmic diagnostic tests discussed in this
article show limited compliance with accepted methodological standards
but are no worse than previously described for evaluations published in
general medical journals. Adherence to these standards by researchers
can improve the study design and reporting of evaluations of new
diagnostic techniques. Limited compliance, combined with a lack of
awareness of the standards among users of research evidence, may lead
to the inappropriate adoption of new diagnostic technologies, with a
consequent waste of health care resources.
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