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Exact(5)
Based on these assumptions, unresected lesions were not included in the analysis because the reference standard of the resected specimens was not obtained in these lesions.
One study is missing in Table 3 because the reference standard was a combination of the findings on autopsy and PMCT [ 32].
Finally, the validity of these findings is uncertain because the reference standard test for illness severity was the unverified final diagnoses made by the treating physicians and not standard, microbiologically based definitions.
Fourth, because the reference standard procedure (MRI with hepato-specific contrast medium) cannot be systematically used to verify the result of US and AFP as surveillance tools, our investigation – as almost all on this topic – suffers from the 'verification bias' that can artificially increase the sensitivity of both tests (Kobayashi et al, 1985).
In the reference standard domain, we judged eleven studies (52%) to be at low risk of bias because the reference standard was appropriate and the results were interpreted without knowledge of the results of the MTBDR sl assay (Ajbani 2012; Barnard 2012; Chikamatsu 2012; Hillemann 2009; Huang 2011; Ignatyeva 2012 Jin 2013; Lopez-Roa 2012 Miotto 2012; Tukvadze 2014; Zivanovic 2012.
Similar(55)
This explains why recent and continuing improvements in imaging technology, with resolution of smaller and smaller lesions, have resulted in little or no improvement in apparent sensitivity, because the reference standards are also improving at about the same rate.
The findings for our sample of middle-aged people in rural Mid-east China indicate that they had better mental health (53.1) but worse physical health (47.8) than the Hong Kong sample, for which PCS and MCS were both 50 because this was the reference standard.
However, this inference is flawed because it assumes that the reference standard, HRA-directed biopsy is a perfect gold standard that results in no misclassification of true disease status.
Because panel review was considered the reference standard, panel review percentages = 100%.
Seven papers [ 23, 30- 32, 35, 36, 38] scored "yes" because the index test and the reference standard were independant instruments.
8 In addition, sensitivity and specificity estimates can differ because of variable definitions of the reference standard against which the test is being compared.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com