156 Chapter 4 Appendix 1. Information leaflet for interviewees Required knowledge to develop diagnostic test recommendations in clinical practice guidelines This study aims to define the minimum knowledge components needed for guideline developers when making recommendations about diagnostic tests and to measure current knowledge among guideline developers. Currently available competencies and competency-based frameworks for guideline developers do not include diagnostic test evaluation [1, 2]. The results of this study provide input for designing specific training programs for guideline panel members when developing diagnostic test recommendations. Definitions and concepts We use the following definitions and concepts: - Clinical practice guidelines: Clinical practice guidelines are statements that include recommendations intended to optimize patient care. To be trustworthy according to the Institute of Medicine, guidelines should: be based on a systematic review of the existing evidence; be developed by a knowledgeable, multidisciplinary panel of experts and representatives from key affected groups; consider important patient subgroups and patient preferences, as appropriate; be based on an explicit transparent process that minimizes distortions, biases, and conflicts of interest; provide a clear explanation of the logical relationships between alternative care options and health outcomes and provide ratings of both the quality of evidence and the strength of recommendations; be reconsidered and revised as appropriate when important new evidence warrants modifications of recommendations [3]. - Diagnostic test: Diagnostic tests are medical tests undertaken in patients who present to health services with signs or symptoms. A medical test refers to any procedure performed on a person’s fluids, cells, tissue, or on the person themself, to detect, diagnose or monitor a condition or the course of a condition. Medical tests come in many different forms, from patient history and physical and visual examination to lab tests and imaging, as well as risk scores that combine multiple pieces of information from different sources [4]. - Diagnostic process: The diagnostic process is an empirical iterative process [5]. It has inductive and deductive elements, based on Bayes’ theorem [6].
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