Resumen

AZEVEDO, Luís Filipe  y  PEREIRA, Altamiro da Costa. Critical Appraisal and Practical Implementation of Diagnostic Tests Accuracy Studies: Part II. Nascer e Crescer [online]. 2010, vol.19, n.4, pp.265-277. ISSN 0872-0754.

Evidence Based Medicine (EBM) is generically defined as the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. This section of Evidence Based Paediatrics has been covering the conceptual, methodological and operational issues related to the practice of EBM in the field of Paediatrics. In the present article we will continue the discussion of the practical example regarding the critical appraisal and practical implementation of diagnostic tests accuracy studies initiated in the previous article of this section. In the present article we will continue the discussion of a clinical scenario where we have searched for and critically appraise scientific evidence about the accuracy of serum procalcitonin in the distinction of bacterial from viral pneumonia in children. In the last article methods for searching the current best evidence were discussed and a systematic approach for the critical appraisal of diagnostic tests accuracy studies was suggested, including: (1) assessment of the methodological quality of the study; (2) assessment of the scientific and practical impact of its results and (3) assessment of their practical applicability. After discussing in the past article the first of this points, in the present article we will be covering methods and concepts concerning the assessment of scientific and practical impact of results (operational characteristics of diagnostic tests and integration of diagnostic information in the clinical decision making process in a bayesian perspective) and their practical applicability.

Palabras clave : Evidence based medicine; diagnosis; diagnostic tests; specificity; sensitivity; predictive values; likelihood ratios; ROC curves; procalcitonin; pneumonia; children.

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