Required knowledge 159 4 Appendix 2. Draft list ‘Required knowledge to develop medical test recommendations in clinical practice guidelines’ Possible required knowledge components ↓ Role in guideline panel Health care provider Health care consumer Methodologist Guideline panel chair Diagnostic process in clinical practice The diagnostic process has inductive elements (to generate a general diagnosis, hypothesis generation) and deductive elements (to confirm or rule out a specific diagnosis, hypothesis testing) The diagnostic process is a combination of sense (e.g., common sense) and science (e.g., scientific evidence) The diagnostic process is based on Bayes' theorem; Bayes' theorem states that the probability of a particular chance depends on a priori chances (here: pretest probability) and the occurrence of events (here: test result) Clinical experience, including gut feelings, is essential in patient care Medical tests can have different purposes (to confirm or exclude a clinical diagnosis, to test the likelihood of a clinical diagnosis, for follow-up of patients) Medical tests are part of a test-treatment pathway The aim of a test is to improve patient relevant outcomes In general, several steps are essential to move from medical test to patient relevant outcome (test-treatment pathway) A test rarely is 100% accurate Test results can be true positive, true negative, false positive, false negative, and inconclusive A test might have side effects, adverse events and complications and can lead to stress (test burden) A test has costs, which may be direct and/or indirect and medical and/or nonmedical A test may have acceptability issues, such as preparation by the patient and travel and waiting time A test result can lead to additional tests and/or treatment Not all patients with a specific (positive or negative) test result get the recommended follow-up test or treatment Treatment following a test result may directly influence patient relevant outcomes
RkJQdWJsaXNoZXIy MTk4NDMw