Improving Your Critical Appraisal Skills #4

Diagnostic Test Studies

If RCTs are the most useful study design, and articles about case control studies are my favorite to read, the use and interpretation of diagnostic tests and the articles that define test characteristics are my favorite to think about, talk about, and teach. I think this is because diagnosis is so core to what a general internist brings to health care. Given my enthusiasm, this topic will be covered in two posts.

Today will cover the design of diagnostic test studies and diagnostic test metrics, probability revision and the use of likelihood ratios, and clinical reasoning using testing and treatment thresholds. The next post will cover receiver operator characteristic curves and common problems with diagnostic test studies: spectrum bias; work up bias; and issues of reproducibility. The second post will also feature a list of fun articles to read.