Systematic reviews of diagnostic tests - a new challenge for laboratory medicine

Article type
Authors
Sandberg S, Oosterhuis WP, Oosterhuis WP
Abstract
Recently the International Federation of Clinical Chemistry (IFCC) has installed a new Committee for the Systematic Reviewing of Laboratory Medicine. The systematic reviewing of diagnostic tests forms a new scientific discipline. Performing these systematic reviews has its own methods, especially concerning the validation of primary studies and the statistical tools used to treat and summarise the material. Recommendations have been made by the Cochrane Methods Working Group on the systematic review of screening and diagnostic tests (http://som.flinders.edu.au/FUSA/Cochrane/ cochrane/ergs.him). The IFCC strongly supports systematic reviewing as a basis for rational laboratory use. The newly formed Committee on Systematic Reviewing for the Management and Education Division of the IFCC has been given the task of trying to stimulate systematic reviewing. This international committee itself is performing a systematic review concerning the diagnostic value of tests on cobalamin and folate deficiency. Using structured search strategies as proposed by NHS Research Centre for Reviews and Dissemination in the UK (http://www.york.ac.uk/inst/crd/search.htm), and validation rules of study results, the data is then summarised resulting in a curve called the summary receiver operating characteristic (SROC) curve. The interrelationship between different tasks forms a problem of special interest. The experience gathered by the committee will be used in workshops. The Cochrane Collaboration is not yet accepting studies of diagnostic accuracy into their main database although there is a growing demand for this.