Premium
La Comprensión de la Dirección de los Sesgos en los Estudios de Certeza de las Pruebas Diagnósticas
Author(s) -
Kohn Michael A.,
Carpenter Christopher R.,
Newman Thomas B.
Publication year - 2013
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12255
Subject(s) - medicine , test (biology) , publication bias , diagnostic accuracy , gold standard (test) , selection bias , statistics , information bias , diagnostic test , sensitivity (control systems) , econometrics , meta analysis , mathematics , pathology , paleontology , biology , emergency medicine , radiology , electronic engineering , engineering
Ordering and interpreting diagnostic tests is a critical part of emergency medicine (EM). In evaluating a study of diagnostic test accuracy, emergency physicians (EPs) need to recognize whether the study uses case–control or cross‐sectional sampling and account for common biases. The authors group biases in studies of test accuracy into five categories: incorporation bias, partial verification bias, differential verification bias, imperfect gold standard bias, and spectrum bias. Other named biases are either equivalent to these biases or subtypes within these broader categories. The authors go beyond identifying a bias and predict the direction of its effect on sensitivity and specificity, providing numerical examples from published test accuracy studies. Understanding the direction of a bias may permit useful inferences from even a flawed study of test accuracy.