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Methods Guide for Medical Test Reviews

COLLECTION June 1, 2012

Effectiveness and comparative effectiveness reviews, systematic reviews of existing research on the effectiveness, comparative effectiveness, and comparative harms of different medical tests, are intended to provide relevant evidence to inform real-world health care decisions for patients, providers, and policymakers. In an effort to improve the transparency, consistency, and scientific rigor of the work of the Effective Health Care (EHC) Program, the Evidence-based Practice Center Program (EPC) has developed a Methods Guide for Medical Test Reviews through a collaborative effort.

This guide is intended to be a practical resource for investigators in the Evidence-based Practice Center program as well as other investigators interested in preparing, conducting, and using systematic reviews of medical tests. The guide provides stepwise instruction for conducting a review. To familiarize new investigators with the methodological framework and guidance outlined in the Methods Guide for Medical Test Reviews, AHRQ has created training modules, a series of 12 slide talks for faculty engaged in educating investigators and clinicians interested in systematic review methods for medical tests.

The Methods Guide for Medical Test Reviews complements the Methods Guide for Effectiveness and Comparative Effectiveness Reviews, which focuses on methods to assess the effectiveness of treatments and interventions. The Methods Guide for Medical Test Reviews applies the same principles used for assessing treatments to the issues and challenges in assessing medical tests and also highlights particular areas where the inherently different qualities of medical tests necessitate a different or variation of the approach to systematic review compared to a review of treatments. Originally posted as a draft for public comment in November 2010, the papers have been revised in response to peer and public review comments. The revised versions are posted below and co-published with the Journal of General Internal Medicine on June 1, 2012 at: https://link.springer.com/journal/11606.

Table of Contents

Download the complete Methods Guide for Medical Test Reviews (PDF, 2.5 MB).

Editorial. Methods Guide for Authors of Systematic Reviews of Medical Tests: A Collaboration Between the Agency for Healthcare Research and Quality (AHRQ) and the Journal of General Internal Medicine.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (33 kb). PDF Help.
Other publication(s): Smetana GW, Umscheid CA, Chang S, et al. Methods Guide for Authors of Systematic Reviews of Medical Tests: a collaboration between the Agency for Healthcare Research and Quality (AHRQ) and the Journal of General Internal Medicine. J Gen Intern Med 2012 Jun;27(Suppl 1):S1-3. PMID: 22648668.

Chapter 1: Introduction to the Methods Guide for Medical Test Reviews.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (231 kb). PDF Help.
Other publication(s): Matchar DB. Chapter 1: Introduction to the Methods Guide for Medical Test Reviews. J Gen Intern Med 2012 Jun;27(Suppl 1):S4-10. PMID: 22648669.

Chapter 2: Developing the Topic and Structuring Systematic Reviews of Medical Tests: Utility of PICOTS, Analytic Frameworks, Decision Trees, and Other Frameworks.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (180 kb). PDF Help.
Other publication(s): Samson D, Schoelles KM. Chapter 2: Medical tests guidance (2) developing the topic and structuring systematic reviews of medical tests: utility of PICOTS, analytical frameworks, decision trees, and other frameworks. J Gen Intern Med 2012 Jun;27(Suppl 1):S11-9. PMID: 22648670.

Chapter 3: Choosing the Important Outcomes for a Systematic Review of a Medical Test.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (220 kb). PDF Help.
Other publication(s): Segal JB. Chapter 3: Choosing the important outcomes for a systematic review of a medical test. J Gen Intern Med 2012 Jun;27(Suppl 1):S20-7. PMID: 22648671.

Chapter 4: Effective Search Strategies for Systematic Reviews of Medical Tests.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (68 kb). PDF Help.
Other publication(s): Relevo R. Chapter 4: Effective search strategies for systematic reviews of medical tests. J Gen Intern Med 2012 Jun;27(Suppl 1):S28-32. PMID: 22648672.

Chapter 5: Assessing Risk of Bias as a Domain of Quality in Medical Test Studies.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (77 kb). PDF Help.
Other publication(s): Santaguida PL, Riley CM, Matchar DB. Chapter 5: Assessing risk of bias as a domain of quality in medical test studies. J Gen Intern Med 2012 Jun;27(Suppl 1):S33-8. PMID: 22648673.

Chapter 6: Assessing Applicability of Medical Test Studies in Systematic Reviews.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (111 kb). PDF Help.
Other publication(s): Hartmann KE, Matchar DB, Chang S. Chapter 6: Assessing applicability of medical test studies in systematic reviews. J Gen Intern Med 2012 Jun;27(Suppl 1):S39-46. PMID: 22648674.

Chapter 7: Grading a Body of Evidence on Diagnostic Tests.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (124 kb). PDF Help.
Other publication(s): Singh S. Chang SM, Matchar DB, et al. Chapter 7: Grading a body of evidence on diagnostic tests. J Gen Intern Med 2012 Jun;27(Suppl 1):S47-55. PMID: 22648675.

Chapter 8: Meta-Analysis of Test Performance When There Is a "Gold Standard."
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (381 kb). PDF Help.
Other publication(s): Trikalinos TA, Balion CM, Coleman CI, et al. Chapter 8: Meta-analysis of test performance when there is a "gold standard." J Gen Intern Med 2012 Jun;27(Suppl 1):S56-66. PMID: 22648676.

Chapter 9: Options for Summarizing Medical Test Performance in the Absence of a “Gold Standard”.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (508 kb). PDF Help.
Other publication(s): Trikalinos TA, Balion CM. Chapter 9: Options for summarizing medical test performance in the absence of a "gold standard." J Gen Intern Med 2012 Jun;27(Suppl 1):S67-75. PMID: 22648677.

Chapter 10: Deciding Whether To Complement a Systematic Review of Medical Tests With Decision Modeling.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (174 kb). PDF Help.
Other publication(s): Trikalinos TA, Kulasingam S, Lawrence WF. Chapter 10: Deciding whether to complement a systematic review of medical tests with decision modeling. J Gen Intern Med 2012 Jun;27(Suppl 1):S76-82. PMID: 22648678.

Chapter 11: Challenges in and Principles for Conducting Systematic Reviews of Genetic Tests Used as Predictive Indicators.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (252 kb). PDF Help.
Other publication(s): Jonas DE, Wilt TJ, Taylor BC, et al. Chapter 11: Challenges in and principles for conducting systematic reviews of genetic tests used as predictive indicators. J Gen Intern Med 2012 Jun;27(Suppl 1):S83-93. PMID: 22648679.

Chapter 12: Systematic Review of Prognostic Tests.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (87 kb). PDF Help.
Other publication(s): Rector TS, Taylor BC, Wilt TJ. Chapter 12: Systematic review of prognostic tests. J Gen Intern Med 2012 Jun;27(Suppl 1):S94-101. PMID: 22648680.

Appendix: Test Performance Metrics.
AHRQ Manuscript: Published 1 June 2012. Select for HTML or PDF File (93 kb). PDF Help.

Page last reviewed August 2021
Page originally created June 2012

Internet Citation: Methods Guide for Medical Test Reviews. Content last reviewed August 2021. Effective Health Care Program, Agency for Healthcare Research and Quality, Rockville, MD.
https://effectivehealthcare.ahrq.gov/products/collections/methods-guidance-tests

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