Cook Chad, Cleland Joshua, Hegedus Eric, Wright Alexis, Hancock Mark
Walsh University, OH, USA.
Franklin Pierce University, Rindge, NH, USA.
J Man Manip Ther. 2014 May;22(2):90-6. doi: 10.1179/2042618613Y.0000000032.
The utility of a dedicated clinical test is dependent on the diagnostic accuracy values and the quality of the study in which the test was examined. Scales allow a summative scoring of bias within a study. At present, there are no scales advocated to measure the bias of diagnostic accuracy studies.
The objective of this study was to create a new diagnostic accuracy quality scale (DAQS) that provides a quantitative summary of the methodological quality of studies evaluating clinical tests and measures.
The study used a four-round Delphi survey designed to create, revise, and develop consensus for a quality scale.
The four-round Delphi involved a work team and a respondent group of experts. An initial round among the work team created a working document, which was then modified and revised, with opportunities to create new items threaded in the second round. Rounds III and IV involved voting on the importance of each of the proposed items and consensus development from the respondent group. Consensus for the selection of an item required a 75% approval for the importance of that item.
Sixteen individuals with a variety of research/professional backgrounds made up the respondent group. Modification and revision of the initial work team instrument created a scale with 21 items that reflected potential areas of methodological bias.
The new scale needs validation through weighted assessment. In addition, there was a large proportion of physical therapist/researchers on the work team and the respondent group.
Systematic reviews allow summation of evidence for clinical tests and scales are essential to critique the quality of the articles included in the review. The DAQS may serve this role for diagnostic accuracy studies.
一项专门的临床检测的效用取决于诊断准确性值以及检测所依据的研究的质量。量表能够对研究中的偏倚进行总结评分。目前，尚无用于衡量诊断准确性研究偏倚的量表。
本研究的目的是创建一种新的诊断准确性质量量表（DAQS），该量表能对评估临床检测和测量方法的研究的方法学质量进行定量总结。
本研究采用四轮德尔菲调查法来创建、修订并就质量量表达成共识。
四轮德尔菲调查涉及一个工作团队和一组专家受访者。工作团队的第一轮调查创建了一份工作文件，随后对其进行修改和修订，第二轮有机会添加新条目。第三轮和第四轮涉及对每个提议条目的重要性进行投票，并在受访者群体中达成共识。选择一个条目的共识要求该条目的重要性获得75%的认可。
受访者群体由16名具有不同研究/专业背景的人员组成。对工作团队最初的工具进行修改和修订后，形成了一个包含21个条目的量表，这些条目反映了方法学偏倚的潜在领域。
新量表需要通过加权评估进行验证。此外，工作团队和受访者群体中物理治疗师/研究人员的比例较大。
系统评价能够汇总临床检测的证据，而量表对于评判纳入评价的文章的质量至关重要。DAQS可能在诊断准确性研究中发挥这一作用。
