In:
International Journal of Technology Assessment in Health Care, Cambridge University Press (CUP), Vol. 26, No. 3 ( 2010-07), p. 354-356
Abstract:
We read the recently published study by Lo Scalzo et al. (4). The study is a short version of a more extensive report published on the Italian Ministry of Health Web site (1). A careful evaluation of both documents reveals several critical issues that cast doubts on the correctness of their conclusions. Usually, decisions about clinical practice should be based on levels of evidence in literature and on the strength of recommendations issued in the guidelines of international scientific societies, many of which rely on the Oxford system (Oxford Center for Evidence based Medicine) ( http://cebm.jr2.ox.ac.uk/docs/level.html ). As far as diagnostic tests are concerned, the Oxford system assigns the highest level of evidence to systematic reviews supported by homogeneous results. The same system assigns the second highest level of evidence to the “independent blind comparison of an appropriate spectrum of consecutive patients all of whom have undergone both the diagnostic test and the reference standard,” while the expert's opinion ranks at the lowest level. Surprisingly, the authors flatly dismissed all sequential studies that fulfill the criteria of independent blind comparison, based on the fact that they were not randomized. At the same time, they cited as source data the results of a questionnaire presented to the attendees of an Italian meeting, never published in literature, which is plainly an “expert opinion.”
Type of Medium:
Online Resource
ISSN:
0266-4623
,
1471-6348
DOI:
10.1017/S0266462310000401
Language:
English
Publisher:
Cambridge University Press (CUP)
Publication Date:
2010
detail.hit.zdb_id:
2020486-3
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