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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 1/2012

Open Access 01-06-2012 | Reviews

Chapter 12: Systematic Review of Prognostic Tests

Authors: Thomas S. Rector, PhD, Brent C. Taylor, PhD, Timothy J. Wilt, MD, MPH

Published in: Journal of General Internal Medicine | Special Issue 1/2012

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Abstract

A number of new biological markers are being studied as predictors of disease or adverse medical events among those who already have a disease. Systematic reviews of this growing literature can help determine whether the available evidence supports use of a new biomarker as a prognostic test that can more accurately place patients into different prognostic groups to improve treatment decisions and the accuracy of outcome predictions. Exemplary reviews of prognostic tests are not widely available, and the methods used to review diagnostic tests do not necessarily address the most important questions about prognostic tests that are used to predict the time-dependent likelihood of future patient outcomes. We provide suggestions for those interested in conducting systematic reviews of a prognostic test. The proposed use of the prognostic test should serve as the framework for a systematic review and to help define the key questions. The outcome probabilities or level of risk and other characteristics of prognostic groups are the most salient statistics for review and perhaps meta-analysis. Reclassification tables can help determine how a prognostic test affects the classification of patients into different prognostic groups, hence their treatment. Review of studies of the association between a potential prognostic test and patient outcomes would have little impact other than to determine whether further development as a prognostic test might be warranted.
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Metadata
Title
Chapter 12: Systematic Review of Prognostic Tests
Authors
Thomas S. Rector, PhD
Brent C. Taylor, PhD
Timothy J. Wilt, MD, MPH
Publication date
01-06-2012
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue Special Issue 1/2012
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-011-1899-y

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Chapter 10: Deciding Whether to Complement a Systematic Review of Medical Tests with Decision Modeling

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