Adherence to Standards for Reporting Diagnostic Accuracy in Emergency Medicine Research

Gallo, Lucas; Hua, Nadia; Mercuri, Mathew; Silveira, Angela; Worster, Andrew

doi:10.1111/acem.13233

Cited by 19 publications

(13 citation statements)

References 13 publications

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“…Only four studies used any version of the general diagnostic STARD reporting guidelines . Adherence to Enhancing the Quality and Transparency of Health Research (EQUATOR) Network reporting guidelines reduces intra‐ and interspecialty variability in communicating scientific methods, results, and clinical implications within the context of previous knowledge, yet guidelines like STARD are too often neglected in emergency medicine …”

Section: Discussionmentioning

confidence: 99%

Accuracy of Dementia Screening Instruments in Emergency Medicine: A Diagnostic Meta‐analysis

Carpenter

Banerjee

Keyes

et al. 2018

Academic Emergency Medicine

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ED-based diagnostic research for dementia screening is limited to a few studies using an inadequate criterion standard with variable masking of interpreter's access to the index test and the criterion standard. Standardizing the geriatric ED cognitive assessment methods, measures, and nomenclature is necessary to reduce uncertainties about diagnostic accuracy, reliability, and relevance in this acute care setting. The AMT-4 is currently the most accurate ED screening instrument to increase the probability of dementia and the Brief Alzheimer's Screen is the most accurate to decrease the probability of dementia. Dementia screening as one marker of vulnerability to initiate comprehensive geriatric assessment is warranted based on test-treatment threshold calculations.

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Section: Discussionmentioning

confidence: 99%

Accuracy of Dementia Screening Instruments in Emergency Medicine: A Diagnostic Meta‐analysis

Carpenter

Banerjee

Keyes

et al. 2018

Academic Emergency Medicine

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“…Additionally, one study used a curvilinear probe and three did not explicitly state that they included both transverse and sagittal views, which may limit the applicability . Moreover, only one of the included studies performed an a priori sample size calculation and none of the studies adhered to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) criteria, which may suggest lower‐quality studies . Future studies should adhere to the STARD criteria to ensure high‐quality research.…”

Section: Limitationsmentioning

confidence: 99%

Point‐of‐Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta‐Analysis

Gottlieb

Holladay

Peksa

2019

Academic Emergency Medicine

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Background: Ocular complaints are common presentations to the emergency department (ED). Among these, retinal detachment can cause significant vision loss if not rapidly diagnosed and referred for appropriate treatment. Point-of-care ultrasound has been suggested to identify the diagnosis rapidly when the ocular examination is limited or the ophthalmology service is not readily available. However, prior studies were limited by small sample sizes, resulting in wide ranges of potential accuracy. The primary outcome for this review was to determine the test characteristics of point-of-care ocular ultrasound for the diagnosis of retinal detachment.Methods: PubMed, CINAHL, Scopus, LILACS, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all prospective and randomized controlled trials assessing the accuracy of point-of-care ultrasound for identifying retinal detachment. Data were dual extracted into a predefined worksheet and quality analysis was performed using the QUADAS-2 tool. Data were summarized and a meta-analysis was performed with planned subgroup analyses by location and provider specialty. This review was registered with PROSPERO CRD42018097288. There was no funding for this review.Results: Eleven studies (n = 844 patients) were identified. Overall, ultrasound was 94.2% (95% confidence interval [CI] = 78.4% to 98.6%) sensitive and 96.3% (95% CI = 89.2% to 98.8%) specific for the diagnosis of retinal detachment with a positive likelihood ratio of 25.2 (95% CI = 8.1 to 78.0) and a negative likelihood ratio of 0.06 (95% CI = 0.01 to 0.25). Subgroup analysis found that ultrasound was more accurate among ED patients, but was not significantly different when performed by ED or non-ED providers.Conclusions: Point-of-care ocular ultrasound is sensitive and specific for the diagnosis of retinal detachment.Future studies should determine the ideal training protocol and the influence of color Doppler and contrastenhanced ultrasound on diagnostic accuracy. O cular complaints are common emergency department (ED) presentations, accounting for approximately 3.4% of all ED visits over a 5-year period. 1 The differential diagnosis of flashes and floaters includes posterior vitreous detachment, retinal detachment, posterior uveitis, vitreous hemorrhage, oculodigital stimulation, rapid eye movements, neovascular age-related macular degeneration, migraine with aura, occipital lobe disorders, and postural hypotension. 2 While most patients will have a benign etiology, up to 10% to 26% of patients presenting with acute onset of flashes or floaters will be diagnosed with a

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“…Following these guidelines are a positive move toward standardized reporting of such trials, reducing the confusion when distinguishing methodologic flaws from reporting flaws. Unfortunately, such guidelines are frequently ignored in emergency medicine diagnostic trials . Another challenge of systematic reviews addressing diagnostic tests are difficulty in measuring publication bias .…”

Section: Paradigm Shiftsmentioning

confidence: 99%

Moving Beyond Diagnostic Accuracy With Systematic Reviews and Meta‐analyses

Zehtabchi

Fatovich

2018

Academic Emergency Medicine

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Adherence to Standards for Reporting Diagnostic Accuracy in Emergency Medicine Research

Cited by 19 publications

References 13 publications

Accuracy of Dementia Screening Instruments in Emergency Medicine: A Diagnostic Meta‐analysis

Accuracy of Dementia Screening Instruments in Emergency Medicine: A Diagnostic Meta‐analysis

Point‐of‐Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta‐Analysis

Moving Beyond Diagnostic Accuracy With Systematic Reviews and Meta‐analyses

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