Diagnostic tests and diagnostic accuracy in surgery

Abstract

This chapter outlines the principles of designing, performing and interpreting high quality studies of diagnostic test accuracy. The basic concepts of diagnostic test accuracy, including sensitivity, spec-ificity, diagnostic odds ratio (DOR), likelihood ratios (LRs) and predictive values, are explained. Sources of bias in diagnostic test accuracy studies are explained with practical examples. The graphical ways to represent the accuracy of a diagnostic test are demonstrated. Issues to consider when interpreting the quality of a published study of test accuracy are outlined using guidelines advocated in the medical literature. Finally, the principles of diagnostic meta-analysis, including bivariate and hierarchical summary receiver operating characteristic methods, are explained. © Springer-Verlag Berlin Heidelberg 2010.