Chapter 6: Assessing Applicability of Medical Test Studies in Systematic Reviews

• Published in: Journal of general internal medicine : JGIM Vol. 27; no. Suppl 1; pp. 39 - 46
• Main Authors: Hartmann, K. E., Matchar, D. B., Chang, S.
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.06.2012; Springer Nature B.V
• Subjects: Abbreviations as Topic; Decision Making; Diagnostic Techniques and Procedures - standards; Evidence-Based Medicine - methods; Evidence-Based Medicine - standards; Guidelines as Topic; Humans; Internal Medicine; Medical tests; Medicine; Medicine & Public Health; Patient Selection; Review Literature as Topic; Reviews; Systematic review; prognostic test; applicability; systematic evidence review; screening test; diagnostic test
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-011-1961-9

Use of medical tests should be guided by research evidence about the accuracy and utility of those tests in clinical care settings. Systematic reviews of the literature about medical tests must address applicability to real-world decision-making. Challenges for reviews include: (1) lack of clarity in key questions about the intended applicability of the review, (2) numerous studies in many populations and settings, (3) publications that provide too little information to assess applicability, (4) secular trends in prevalence and the spectrum of the condition for which the test is done, and (5) changes in the technology of the test itself. We describe principles for crafting reviews that meet these challenges and capture the key elements from the literature necessary to understand applicability.