Radboud University Nijmegen Medical Centre, Academic Educational Institute, Nijmegen, the NetherlandsBehavioural Science Institute, Radboud University Nijmegen, Nijmegen, the NetherlandsDepartment of General Internal Medicine and Academic Educational Institute, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
Med Educ. 2010 Sep;44(9):874-883. doi: 10.1111/j.1365-2923.2010.03721.x.
Research on objective structured clinical examinations (OSCEs) is extensive. However, relatively little has been written on the development of case-specific checklists on history taking and physical examination. Background information on the development of these checklists is a key element of the assessment of their content validity. Usually, expert panels are involved in the development of checklists. The objective of this study is to compare expert-based items on OSCE checklists with evidence-based items identified in the literature.
Evidence-based items covering both history taking and physical examination for specific clinical problems and diseases were identified in the literature. Items on nine expert-based checklists for OSCE examination stations were evaluated by comparing them with items identified in the literature. The data were grouped into three categories: (i) expert-based items; (ii) evidence-based items, and (iii) evidence-based items with a specific measure of their relevance.
Out of 227 expert-based items, 58 (26%) were not found in the literature. Of 388 evidence-based items found in the literature, 219 (56%) were not included in the expert-based checklists. Of these 219 items, 82 (37%) had a specific measure of importance, such as an odds ratio for a diagnosis, making that diagnosis more or less probable.
Expert-based, case-specific checklist items developed for OSCE stations do not coincide with evidence-based items identified in the literature. Further research is needed to ascertain what this inconsistency means for test validity.
关于客观结构化临床考试（OSCE）的研究很多。但是，关于病史采集和体格检查的特定案例检查表的开发，相关研究相对较少。这些检查表的背景信息是评估其内容效度的关键要素。通常，专家小组参与检查表的开发。本研究的目的是比较 OSCE 检查表中基于专家的项目与文献中确定的基于证据的项目。
在文献中确定了针对特定临床问题和疾病的病史采集和体格检查的基于证据的项目。通过将九个基于专家的 OSCE 检查点检查表上的项目与文献中确定的项目进行比较，对其进行评估。这些数据分为三类：（i）基于专家的项目；（ii）基于证据的项目；（iii）基于证据的项目及其相关特定度量。
在 227 个基于专家的项目中，有 58 个（26%）未在文献中找到。在文献中发现的 388 个基于证据的项目中，有 219 个（56%）未包含在基于专家的检查表中。在这 219 个项目中，有 82 个（37%）具有特定的重要性度量，例如诊断的优势比，使该诊断更有可能或不太可能发生。
为 OSCE 站开发的基于专家的特定案例检查表项目与文献中确定的基于证据的项目不相符。需要进一步研究以确定这种不一致对测试有效性意味着什么。
