Bravata Dena M, Sundaram Vandana, McDonald Kathryn M, Smith Wendy M, Szeto Herbert, Schleinitz Mark D, Owens Douglas K
University of California San Francisco-Stanford Evidence-based Practice Center, Stanford, California, USA.
Emerg Infect Dis. 2004 Jan;10(1):100-8. doi: 10.3201/eid1001.030243.
We evaluated the usefulness of detection systems and diagnostic decision support systems for bioterrorism response. We performed a systematic review by searching relevant databases (e.g., MEDLINE) and Web sites for reports of detection systems and diagnostic decision support systems that could be used during bioterrorism responses. We reviewed over 24,000 citations and identified 55 detection systems and 23 diagnostic decision support systems. Only 35 systems have been evaluated: 4 reported both sensitivity and specificity, 13 were compared to a reference standard, and 31 were evaluated for their timeliness. Most evaluations of detection systems and some evaluations of diagnostic systems for bioterrorism responses are critically deficient. Because false-positive and false-negative rates are unknown for most systems, decision making on the basis of these systems is seriously compromised. We describe a framework for the design of future evaluations of such systems.
我们评估了用于生物恐怖主义应对的检测系统和诊断决策支持系统的实用性。我们通过搜索相关数据库（如MEDLINE）和网站，对可用于生物恐怖主义应对的检测系统和诊断决策支持系统的报告进行了系统综述。我们查阅了超过24,000篇文献，确定了55个检测系统和23个诊断决策支持系统。仅对35个系统进行了评估：4个报告了灵敏度和特异性，13个与参考标准进行了比较，31个评估了其及时性。大多数生物恐怖主义应对检测系统的评估以及一些诊断系统的评估都存在严重缺陷。由于大多数系统的假阳性和假阴性率未知，基于这些系统的决策受到严重影响。我们描述了此类系统未来评估设计的框架。
