Users' guides to the medical literature. III. How to use an article about a diagnostic test. A. Are the results of the study valid? Evidence-Based Medicine Working Group

Jaeschke, Roman; Guyatt, Gordon; Dl, Sackett

doi:10.1001/jama.271.5.389

Cited by 605 publications

(527 citation statements)

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“…The diagnostic utility of a specific instrument to determine whether or not a patient has a target condition should be investigated in a random sample of the indicated population, i.e., patients suspected of the target condition (Jaeschke et al 1994). The quality of an instrument to distinguish severely affected children, as children with autism are, from healthy children, tells us nothing about the clinical utility of the instrument.…”

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confidence: 99%

“…The quality of an instrument to distinguish severely affected children, as children with autism are, from healthy children, tells us nothing about the clinical utility of the instrument. In addition, case-control study designs which compare the target condition with people who have clearly other disorders, overestimate the diagnostic utility of an instrument (Jaeschke et al 1994). This review revealed that imitation studies in preschoolers with autism were all case-control studies.…”

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confidence: 99%

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Imitation Assessment and Its Utility to the Diagnosis of Autism: Evidence from Consecutive Clinical Preschool Referrals for Suspected Autism

Vanvuchelen

Roeyers

Weerdt

2010

J Autism Dev Disord

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The present study sought to examine imitation difficulties as a risk factor for autism. Imitation aptitude was examined in 86 preschoolers suspected of autism (1.9-4.5 years) using the Preschool Imitation and Praxis Scale (PIPS). Differences between imitation, language, motor age-equivalents and nonverbal mental age were used to predict the diagnosis of autism. Multidisciplinary team diagnoses and ADOS-G classifications were used to differentiate children with autism spectrum disorders and non-spectrum developmental disorders. Two factors were found to be significantly associated with autism using simple logistic regression analyses: procedural imitation delay and receptive language delay. In a multivariable setting, only procedural imitation delay remained a significant predictor of autism. Results are new to the literature and require replications.

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confidence: 99%

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confidence: 99%

Imitation Assessment and Its Utility to the Diagnosis of Autism: Evidence from Consecutive Clinical Preschool Referrals for Suspected Autism

Vanvuchelen

Roeyers

Weerdt

2010

J Autism Dev Disord

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“…Therefore, we suggest that neurological deficit as one possible predictive factor should be carefully assessed and identified as an important subject recruitment criteria while planning randomized control trial. Low FABQ-W score (B21) predicted 3.07 (OR) times (1.05-9.01 95%CI) more benefit from the traction approach than those patients had high fear-avoidance to work (FABQW [21). It is not surprising considering that fearmotivated behaviour has the potential to adversely impact treatment outcomes for patients with musculoskeletal pain [12].…”

Section: Discussionmentioning

confidence: 99%

“…According to Jaeschke et al [21], accuracy is moderate when the PLR is greater than 5.0 or the negative likelihood ratio (NLR) is less than 0.20, while accuracy is substantial when the PLR is greater than 10.0 or NLR is less than 0.10. In our study the PLR of identifying responder of mechanical lumbar traction increased with the presence of three out of four positive variables from 3.04 to 9.36 with the presence of all four variables.…”

Section: Discussionmentioning

confidence: 99%

A clinical prediction rule for classifying patients with low back pain who demonstrate short-term improvement with mechanical lumbar traction

2009

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The objective of the study was to develop a clinical prediction rule for identifying patients with low back pain, who improved with mechanical lumbar traction. A prospective, cohort study was conducted in a physiotherapy clinic at a local hospital. Patients with low back pain, referred to physiotherapy were included in the study. The intervention was a standardized mechanical lumbar traction program, which comprised three sessions provided within 9 days. Patient demographic information, standard physical examination, numeric pain scale, fear-avoidance beliefs questionnaire and Oswestry low back pain disability index (pre-and post-intervention) were recorded. A total of 129 patients participated in the study and 25 had positive response to the mechanical lumbar traction. A clinical prediction rule with four variables (non-involvement of manual work, low level fear-avoidance beliefs, no neurological deficit and age above 30 years) was identified. The presence of all four variables (positive likelihood ratio = 9.36) increased the probability of response rate with mechanical lumbar traction from 19.4 to 69.2%. It appears that patients with low back pain who were likely to respond to mechanical lumbar traction may be identified.

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“…Explicit criteria are used for the assessment of the validity of trial results and the quality of the methodology according to the type of publication (Guyatt et al, 1993(Guyatt et al, , 1997Oxman et al, 1993Oxman et al, , 1994Jaeschke et al, 1994aJaeschke et al, , 1994bLaupacis et al, 1994;Levine et al, 1994;Hayward et al, 1995). To improve methodological rigor, to limit bias in the selection of relevant studies and to facilitate the data review process, critical appraisal checklists have been developed for different types of publications (Fervers, 2000).…”

Section: Critical Appraisal Of the Evidencementioning

confidence: 99%

SOR: project methodology

et al. 2001

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