Urogenit Tract Infect.  2020 Apr;15(1):16-25. 10.14777/uti.2020.15.1.16.

Korean Translation of the GRADE Series Published in the BMJ, ‘GRADE: Grading Quality of Evidence and Strength of Recommendations for Diagnostic Tests and Strategies’ (A Secondary Publication)

Affiliations
  • 1Department of Urology, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 2Department of nstitute of Evidence-Based Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
  • 3Department of Urology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
  • 4Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea
  • 5Department of Urology, Pusan National University Hospital, Busan, Korea
  • 6Department of Urology, Daegu Catholic University School of Medicine, Daegu, Korea
  • 7Department of Urology, College of Medicine, Konyang University, Daejeon, Korea
  • 8Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea

Abstract

This article is the fourth translation of a GRADE series published in the BMJ, which graded the quality of evidence and strength of recommendations for diagnostic tests or strategies, as a comprehensive and transparent approach for developing recommendations. Randomized trials for diagnostic approaches represent the ideal study design for intervention studies. On the other hand, cross-sectional or cohort studies with a direct comparison of the test results with an appropriate reference standard can provide high-quality evidence. The guideline panel must be reminded that the test accuracy is a surrogate for patient-important outcomes, so such studies often provide a low quality of evidence for recommendations regarding diagnostic tests, even when the studies do not have serious limitations. Diagnostic accuracy studies showing that a diagnostic test or strategy improves important patient outcomes will require the availability of effective treatment, reduction of testrelated adverse effects or anxiety, or improvement of the patients’ well-being from prognostic information. Therefore, it is important to assess the directness of the test results regarding the consequences of diagnostic recommendations that are important to patients.

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