Diagnosis and Levels of Evidence in WM

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Diagnostic Testing is not always supported by research in WM

 

http://www.medscape.com/viewarticle/464453?

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Senior author Dr. P. J. Sullivan, at Hope Hospital in Manchester,

UK, and colleagues reviewed case notes of 90 patients to identify

clinical tests and why they had been ordered.

 

They then searched Medline for the 38 " test-question combinations "

and graded the levels of evidence according to criteria from the

Centre for Evidence Based Medicine in Oxford.

 

Of 165 tests, only about half were supported by 1a-1c evidence:

systematic reviews of level 1 studies with homogeneity, prospective

cohort studies with good reference standards, or regarded as

absolutely specific or sensitive.

 

In fact, the investigators found that there were no studies that

evaluated serial chest x-rays to exclude lung cancer, ESR to

diagnose TB, exercise oximetry for lung disease and serum

immunoglobulin E concentration to help diagnose asthma.