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Chapter 12: Systematic Review of Prognostic Tests
Open accessAbstract
A number of new biological markers are being studied as predictors of disease or adverse medical events among those who already have a disease. Systematic reviews of this growing literature can help determine whether the available evidence supports use of a new biomarker as a prognostic test that can more accurately place patients into different prognostic groups to improve treatment decisions and the accuracy of outcome predictions. Exemplary reviews of prognostic tests are not widely available, and the methods used to review diagnostic tests do not necessarily address the most important questions about prognostic tests that are used to predict the time-dependent likelihood of future patient outcomes. We provide suggestions for those interested in conducting systematic reviews of a prognostic test. The proposed use of the prognostic test should serve as the framework for a systematic review and to help define the key questions. The outcome probabilities or level of risk and other characteristics of prognostic groups are the most salient statistics for review and perhaps meta-analysis. Reclassification tables can help determine how a prognostic test affects the classification of patients into different prognostic groups, hence their treatment. Review of studies of the association between a potential prognostic test and patient outcomes would have little impact other than to determine whether further development as a prognostic test might be warranted.
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“Therefore, it remains unclear how the predictive biomarker should be used in daily practice (Rector et al., 2012).”
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Metadata
- Authors
- Rector, T. S., Taylor, B. C., & Wilt, T. J.
- Affiliations
- University of Minnesota (US)
- Corresponding author
- Rector, Thomas S.
- Venue
- Journal of General Internal Medicine
- Published
- 2012-05-31
- Volume
- 27
- Issue
- S1
- Pages
- 94-101
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC3364355
- OpenAlex
- W1965892460
- Cited by
- 37
- References
- 52
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 4 · 2019: 3 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 2 · 2012: 4
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of General Internal Medicine (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services
- U.S. Department of Veterans Affairs
- Agency for Healthcare Research and Quality
- Topics
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- prognostic tests, prognostic factors, systematic review methodology, prognostic subgroups, risk prediction, treatment decision-making
- MeSH terms
- Humans, Prognosis, Review Literature as Topic, Biomarkers, Evidence-Based Medicine, Diagnostic Techniques and Procedures, Comparative Effectiveness Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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