On May 28-29, 2008, AHRQ hosted a working meeting to discuss particularly challenging methodological issues in assessing medical tests. This working meeting included a group of investigators from the Evidence-based Practice Centers (EPCs), other experts in government, industry, and academia and also marked the launch of a Medical Test Evaluation Work Group within the EPC program. This Work Group was charged with developing guidance for conducting comparative effectiveness reviews of medical test technologies for the AHRQ Effective Health Care Program. A series of scientific publications (white papers) were commissioned for the meeting. These white papers have been published in Medical Decision Making and were intended to serve as background papers for the Work Group, which is expected to complete their draft guidance in the first part of 2010.

Contents

• Decision-Analytic Modeling to Evaluate Benefits and Harms of Medical Tests—Uses and Limitations
  Thomas A Trikalinos, MD, Uwe Siebert, MD, MPH, MSc, ScD, and Joseph Lau, MD.
  Published: November 9, 2009.
  • Introduction
  • Using Modeling To Interpret Evidence on Medical Test Performance
  • Challenges in Modeling Test-and-Treat Strategies
  • Final Remarks
  • References
• Using the Principles of Randomized Controlled Trial Design To Guide Test Evaluation
  Sarah J Lord, MBBS, MS, Les Irwig, MBBCh, PhD, and Patrick MM Bossuyt, PhD.
  Published: November 9, 2009.
  • Introduction
  • Using the RCT Analogy in Test Evaluation
  • Constructing a Test Evaluation Flow Diagram
  • Identifying the Type of Comparative Evidence Needed for Test Evaluation
  • Discussion
  • References
• Proposals for a Phased Evaluation of Medical Tests
  Jeroen G Lijmer, MD, PhD, Mariska Leeflang, PhD, and Patrick MM Bossuyt, PhD.
  Published: November 9, 2009.
  • Introduction
  • Literature Search
  • Hierarchical Models: A Synthesis
  • Discussion
  • References
• Additional Patient Outcomes and Pathways in Evaluations of Testing
  Patrick MM Bossuyt, PhD and Kirsten McCaffery, PhD.
  Published: November 9, 2009.
  • Introduction
  • Clinical Management Effects and Direct Effects of Testing
  • Emotional Effects of Testing
  • Social Effects of Testing
  • Cognitive Effects of Testing
  • Behavioral Effects of Testing
  • Patient Outcome After Testing: The Big Picture
  • Conclusion
  • References