The Evidence Base of Clinical Diagnosis

Frank Buntinx, Professor, Department of Public Health, Leuven University. He is one time chair of the Cochrane Collaboration Diagnostic and Screening Tests Working Group Andre Knottnerus, Professor of General Practice, Maastricht University. He is involved in the Cochrane movement for drawing up tools for accurate diagnostic testing The Evidence Base of Clinical Diagnosis was published by BMJ Books in 2002, and was based on a popular series published in the British Medical Journal. At that time it was unique in addressing evidence-based issues in the field of clinical diagnosis, and was enthusiastically received by the clinical research community for its thorough and insightful analysis of research methods in diagnosis. The information on effectiveness of clinical diagnosis tools was even more diffuse and sparse than now, and so the book became a point of reference for evidence-based diagnosis. The main basis for the text was discussion of diagnostic research tools and what evidence was available for their efficacy. The case for a new edition The first edition is now over 3 years old Since publication much more information has been made available, including more clinically relevant data for problem solving and ordering diagnostic tests. The evidence-based health care community has turned the spotlight on diagnosis and it has become one of the hot topics in ebm. A new, more clinically focused edition of this well established book will be timely. Special features of the new edition * Two new chapters will be added: one covering the recently published STARD guidelines (Standards for Reporting on Accuracy Research on Diagnosis); the second on the analysis of diagnostic data. * Chapter 2 will discuss the connection between diagnostic research and study design * Chapter 6 will focus on evaluating the external validity of diagnostic research data. * Chapter 8 will present the latest developments in diagnosis from the Cochrane Collaboration. * Chapter 9 will discuss expert systems for diagnostic decision support. * Chapters 10 and 11 will be updated and extended, discussing the practical implications of scientific knowledge for clinical problem solving and test ordering CONTENTS 1. General introduction: evaluation of diagnostic procedures: J André Knottnerus, Frank Buntinx and Chris van Weel. 2. The architecture of diagnostic research: R. Brian Haynes and John You. 3. Assessment of the accuracy of diagnostic tests: the cross-sectional study: J André Knottnerus and Jean W Muris. 4. Diagnostic Testing and Prognosis: The randomised controlled trial in test evaluation research: Jeroen G. Lijmer and Patrick M.M. Bossuyt. 5. The diagnostic before-after study to assess clinical impact: J André Knottnerus, Geert-Jan Dinant and Onno P van Schayck. 6. Designing studies to ensure that estimates of test accuracy will travel: Les M Irwig, Patrick M Bossuyt, Paul P Glasziou, Constantine Gatsonis and Jeroen G Lijmer. 7. Analysis of data on the accuracy of diagnostic tests: J Dik F Habbema, René Eijkemans, Pieta Krijnen and J André Knottnerus. 8. Multivariable analysis in diagnostic accuracy studies. What are the possibilities? F. Buntinx, B. Aertgeerts, M. Aerts, R. Bruyninckx, J.A. Knottnerus, A. Van den Bruel and J. Van den Ende. 9. Standards of reporting on diagnostic accuracy studies: P. Bossuyt and Nynke Smidt. 10. Guidelines for conducting systematic reviews of studies evaluating the accuracy of diagnostic tests: Frank Buntinx, Bert Aertgeerts and Petra Macaskill. 11. Producing and using clinical prediction rules: Tom Fahey and Johan Van der Lei. 12. Clinical problem solving and diagnostic decision making: a selective review of the cognitive research literature:. Alan Schwartz and Arthur S Elstein. 13. Improving test ordering and its diagnostic cost effectiveness in clinical practice - bridging the gap between clinical research and routine health care: Ron A.G. Winkens, Trudy van der Weijden, Hans Severens, Geert-Jan Dinant. 14. Epilogue: overview of evaluation strategy and challenges: J André Knottnerus, Ann van den Bruel and Frank Buntinx