Article type
Year
Abstract
Background: Oral cancer has been identified as a high priority area of research for the Cochrane Oral Health Group (COHG). Oral cancer is the sixth most common cancer globally, with incidence increasing worldwide. External funding from the National Institutes of Health (USA) to members of editorial staff of the COHG enabled four intervention reviews in the treatment of oral cancers and screening programmes for the early detection and prevention of oral cancer to be carried out. A diagnostic test accuracy (DTA) review for screening and diagnosis of oral cancer was identified as a priority review for the group.
Objectives: To document the issues encountered by the review team and COHG editorial staff in undertaking their first DTA review.
Methods: Editorial staff received training on the methods and processes involved for the production of DTA reviews. A multidisciplinary review team comprising clinicians, a statistician and a methodologist was formed to write the review, with input from an expert panel of oncologists. At least one review author was required to attend four DTA workshops.
Results: Formulating the research question was difficult, as substantial prior clinical and methodological knowledge was required at the outset. Standard diagnostic practice was not always 'standard’ index tests could be quite esoteric but still needed to be specified a priori; reference standard differed between comparisons. A scoping literature search and guidance from the Trials Search Co-ordinator were essential. From scoping two separate but related research questions emerged. Moving from basic analysis required detailed statistical knowledge and input. Detailed knowledge of study design (usually not randomised controlled trials) and clinical experience of target disease were needed to properly evaluate methodological quality.
Conclusions: In our experience, DTA reviews are more difficult than intervention reviews, but not impossible. They require a very clear understanding of the nature of the problem and current clinical practice, and commitment from a multidisciplinary team.
Objectives: To document the issues encountered by the review team and COHG editorial staff in undertaking their first DTA review.
Methods: Editorial staff received training on the methods and processes involved for the production of DTA reviews. A multidisciplinary review team comprising clinicians, a statistician and a methodologist was formed to write the review, with input from an expert panel of oncologists. At least one review author was required to attend four DTA workshops.
Results: Formulating the research question was difficult, as substantial prior clinical and methodological knowledge was required at the outset. Standard diagnostic practice was not always 'standard’ index tests could be quite esoteric but still needed to be specified a priori; reference standard differed between comparisons. A scoping literature search and guidance from the Trials Search Co-ordinator were essential. From scoping two separate but related research questions emerged. Moving from basic analysis required detailed statistical knowledge and input. Detailed knowledge of study design (usually not randomised controlled trials) and clinical experience of target disease were needed to properly evaluate methodological quality.
Conclusions: In our experience, DTA reviews are more difficult than intervention reviews, but not impossible. They require a very clear understanding of the nature of the problem and current clinical practice, and commitment from a multidisciplinary team.