The assessment of diagnostic tests. A survey of current medical research

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Abstract
To study current diagnostic test evaluation, 129 recent articles were assessed against several well-known methodological criteria. Only 68% employed a well-defined gold standard. Test interpretation was clearly described in only 68% and was stated to be blind in only 40%. Approximately 20% used the terms sensitivity and specificity incorrectly. Predictive values were considered in only 31% and the influence of diseases prevalence and study setting was considered in only 19%. Overall, 74% failed to demonstrate more than 4 of 7 important characteristics and there was an increased proportion of high specificities reported in this group. Articles assessing new tests reported high sensitivities and specificities significantly more often than articles assessing existing tests. There is a clear need for greater attention to accepted methodological standards on the part of researchers, reviewers and editors.