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Enhancing the acceptance and implementation of GRADE summary of findings tables for evidence about diagnostic tests

Date and Location




Friday 20 September 2013 - 13:30 - 15:00


Presenting author and contact person

Presenting author

Reem Mustafa

Contact person

Reem Mustafa
Abstract text
Background: The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group developed Summary tables adapted to summarise and present evidence from diagnostic test accuracy (DTA) systematic reviews. Objective: To develop guidance on what information to include in these summary tables and to determine the best method(s) for presentation for different end users, including healthcare providers, systematic reviewers and guideline developers. Methods: We presented a number of alternative summary tables to different users of the Cochrane library including authors of diagnostic systematic reviews, physicians and guideline developers. We conducted questionnaires and one-on-one user testing interviews with target end users. We presented printed copies of summary tables and asked open-ended and 7-point Likert-scale questions to obtain information about users’ understanding and preferences. Results: All participants (n=60) agreed that using summary tables to present results of DTA reviews is helpful. Presentation of several disease prevalence values was identified as a source of confusion. There was an overall preference for placement of sensitivity and specificity values inside summary tables to allow making a link to individual test results (TP, FN, TN, FP). A third of the participants read explanatory content in table footnotes. Two thirds of the participants noted that additional data, including adverse effects, costs, and treatment consequences, would be helpful for making appropriate conclusions and decisions about diagnostic tests. Conclusion: As results of DTA reviews are conceptually complicated, presenting the data in a clear, comprehensive, comprehensible way that is tailored to different end users is critical. To respond to different end users needs, we are developing a 3-layer approach, with varied content in summary tables.