Review of Diagnostic Test Accuracy (DTA) studies in older people

Takwoingi, Y. and Quinn, T. (2018) Review of Diagnostic Test Accuracy (DTA) studies in older people. Age and Ageing, 47(3), pp. 349-355. (doi: 10.1093/ageing/afy023) (PMID:29528366)

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Abstract

Diagnostic Test Accuracy (DTA) describes a field of research that aims to assess how well a test is able to detect or exclude a condition of interest. Although geriatric medicine is not as reliant on investigations as other medical disciplines, almost all patient encounters with older adults will involve some form of diagnostic assessment. Thus, understanding the terminology and methods of DTA is essential for any clinician. In this review we use examples based around the diagnosis of dementia to highlight issues in DTA research. Some of these are generic to any DTA research and some are particularly pertinent to older adults. One can apply a test accuracy framework to a clinical question by defining four key components: the condition of interest; the index test(s) (i.e. the assessment(s) of interest); the reference standard (the best available method for assessing the condition of interest) and the population or healthcare setting in which testing takes place. Test accuracy is often described using complementary measures of sensitivity and specificity. However, many other metrics to describe test accuracy are available; in clinical practice predictive values may have greater utility. These and other descriptive statistics can be derived from a two by two table that cross-classifies the index test results with the reference standard results. Test performance and utility is not only determined by accuracy, other measures such as feasibility and acceptability should be considered and may be of particular importance when describing test performance in older adults with physical and cognitive impairments.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Quinn, Professor Terry
Authors: Takwoingi, Y., and Quinn, T.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Age and Ageing
Publisher:Oxford University Press
ISSN:0002-0729
ISSN (Online):1468-2834
Published Online:08 March 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Age and Ageing 47(3):349-355
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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