Current methods for development of rapid reviews about diagnostic tests: an international survey

Background Rapid reviews (RRs) have emerged as an efficient alternative to time-consuming systematic reviews—they can help meet the demand for accelerated evidence synthesis to inform decision-making in healthcare. The synthesis of diagnostic evidence has important methodological challenges. Here, we performed an international survey to identify the current practice of producing RRs for diagnostic tests. Methods We developed and administered an online survey inviting institutions that perform RRs of diagnostic tests from all over the world. Results All participants (N = 25) reported the implementation of one or more methods to define the scope of the RR; however, only one strategy (defining a structured question) was used by ≥90% of participants. All participants used at least one methodological shortcut including the use of a previous review as a starting point (92%) and the use of limits on the search (96%). Parallelization and automation of review tasks were not extensively used (48 and 20%, respectively). Conclusion Our survey indicates a greater use of shortcuts and limits for conducting diagnostic test RRs versus the results of a recent scoping review analyzing published RRs. Several shortcuts are used without knowing how their implementation affects the results of the evidence synthesis in the setting of diagnostic test reviews. Thus, a structured evaluation of the challenges and implications of the adoption of these RR methods is warranted

Challenges of rapid reviews for diagnostic test accuracy questions: a protocol for an international survey and expert consultation

Background: Assessment of diagnostic tests, broadly defined as any element that aids in the collection of additional information for further clarification of a patient’s health status, has increasingly become a critical issue in health policy and decision-making. Diagnostic evidence, including the accuracy of a medical test for a target condition, is commonly appraised using standard systematic review methodology. Owing to the considerable time and resources required to conduct these, rapid reviews have emerged as a pragmatic alternative by tailoring methods according to the decision maker’s circumstances. However, it is not known if streamlining methodological aspects has an impact on the validity of evidence synthesis. Furthermore, due to the particular nature and complexity of the appraisal of diagnostic accuracy, there is need for detailed guidance on how to conduct rapid reviews of diagnostic tests. In this study, we aim to identify the methods currently used by rapid review developers to synthesize evidence on diagnostic test accuracy, as well as to analyze potential shortcomings and challenges related to these methods. Methods: We will carry out a two-fold approach: (1) an international survey of professionals working in organizations that develop rapid reviews of diagnostic tests, in terms of the methods and resources used by these agencies when conducting rapid reviews, and (2) semi-structured interviews with senior-level individuals to further explore and validate the findings from the survey and to identify challenges in conducting rapid reviews. We will use STATA 15.0 for quantitative analyses and framework analysis for qualitative analyses. We will ensure protection of data during all stages. Discussion: The main result of this research will be a map of methods and resources currently used for conducting rapid reviews of diagnostic test accuracy, as well as methodological shortcomings and potential solutions in diagnostic knowledge synthesis that require further research

Coloração de Ziehl-Neelsen como método rápido de diagnóstico de paratuberculose ovina Ziehl-Neelsen staining as a fast method in the diagnosis of ovine paratuberculosis

Estudou-se a presença de bacilos álcool-ácido resistentes compatíveis com Mycobacterium avium subsp. paratuberculosis em esfregaços de fezes e tecidos de ovinos. Vinte e seis esfregaços de fezes e 104 de tecidos, pertencentes a 26 animais diagnosticados como paratuberculosos, foram analisados pelo método de Ziehl-Neelsen. Dezesseis (61,5%) esfregaços fecais apresentaram bacilos álcool-ácido resistentes compatíveis no exame microscópico. Vinte animais (76,9%) foram diagnosticados pelo método nos esfregaços de tecidos. Vinte e um animais apresentaram esfregaços positivos nas fezes e nos tecidos, simultaneamente. A sensibilidade de Ziehl-Neelsen para os esfregaços fecais, esfregaços de tecidos e para a combinação de ambos foi de 61,5%, 76,9% e 80,8%, respectivamente.<br>The presence of acid-fast bacilli compatible with Mycobacterium avium subsp. paratuberculosis in fecal and tissues smears was investigated using the Ziehl-Neelsen staining. A total of 26 fecal smears and 104 tissues smears collected from 26 sheep with confirmed paratuberculosis were analyzed. Sixteen (61.5%) fecal smears showed compatible with acid-fast bacilli on microscopic examination after staining. Twenty animals (76.9%) were diagnosed based on the positivity of tissues smears. The Ziehl-Neelsen sensitivities to faecal smears, tissues smears, and a combination of both were 61.5%, 76.9%, and 80.8%, respectively