OA Epidemiology

Panel diagnosis as Reference Standard in diagnostic research: A systematic review and methodological recommendations

Proceedings of the 2013 annual meeting of the Netherlands Epidemiology Society

Volume 1 Issue S1 Abstract 2

 

L.C.M. Bertens, Julius Center, University Medical Center, Utrecht
B.D.L. Broekhuizen, Julius Center, University Medical Center, Utrecht
C.A. Naaktgeboren, Julius Center, University Medical Center, Utrecht
F.H. Rutten, Julius Center, University Medical Center, Utrecht
A.W. Hoes, Julius Center, University Medical Center, Utrecht
Y. van Mourik, Julius Center, University Medical Center, Utrecht
K.G.M. Moons, Julius Center, University Medical Center, Utrecht
J.B. Reitsma, Julius Center, University Medical Center, Utrecht

Background
In diagnostic studies, a single and error-free test to make the final diagnosis often does not exist. One solution is to use panel diagnosis, in which the various test results are assessed by multiple experts to reach a final diagnosis in each patient. Although panel diagnosis is frequently used, guidance on preferred methodology is lacking. Therefore we conducted a systematic review to summarize the methodology currently applied and identify areas for improvement.

Methods
PubMed was searched for diagnostic studies in which the final diagnosis was made by two or more experts based on results from multiple tests. General study characteristics and details of panel methodology were extracted.

Results
Eighty-one studies were included. Data extraction was hampered by incomplete reporting; one or more pieces of critical information about panel reference standard methodology was missing in 83% of studies. In most studies (65%), the panel consisted of three or less members. Panel members were not blinded to the results of the test under evaluation in
69% of studies. Choices in panel constitution, the number of test results and other information available to the panel, and methods of decision-making varied largely between studies.

Conclusions
Methods of panel diagnosis varied substantially across studies and many key features were insufficiently reported. Panel constitution, information available to panel members and methods of decision making were identified as the key items of panel methodology. Based on our review we developed a checklist that can assist researchers in designing a diagnostic study in which panel diagnosis is used.

Published: 06 Jun, 2013

 
Licensee OA Publishing London 2013. Creative Commons Attribution License (CC-BY)