12 research outputs found

    Erratum to: Methods for evaluating medical tests and biomarkers

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    [This corrects the article DOI: 10.1186/s41512-016-0001-y.]

    Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

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    Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

    Erratum to: Methods for evaluating medical tests and biomarkers

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    [This corrects the article DOI: 10.1186/s41512-016-0001-y.]

    Sex Differences in Mental Rotation and How They Add to the Understanding of Autism

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    The most consistent cognitive sex differences have been found in the visuo-spatial domain, using Mental Rotation (MR) tasks. Such sex differences have been suggested to bear implications on our understanding of autism spectrum disorders (ASD). However, it is still debated how the sex difference in MR performance relates to differences between individuals with ASD compared to typically developed control persons (TD). To provide a detailed exploration of sex differences in MR performance, we studied rotational (indicated by slopes) and non-rotational aspects (indicated by intercepts) of the MR task in TD individuals (total N = 50). Second-to-fourth digit length ratios (2D:4D) were measured to investigate the associations between prenatal testosterone and performance on MR tasks. Handedness was assessed by the use of the Edinburgh Handedness Inventory in order to examine the relation between handedness and MR performance. In addition, we investigated the relation of spatial to systemising abilities, both of which have been associated with sex differences and with ASD, employing the Intuitive Physics Test (IPT). Results showed a male advantage in rotational aspects of the MR task, which correlated with IPT results. These findings are in contrast to the MR performance of individuals with ASD who have been shown to outperform TD persons in the non-rotational aspects of the MR task. These results suggest that the differences in MR performance due to ASD are different from sex-related differences in TD persons, in other words, ASD is not a simple and continuous extension of the male cognitive profile into the psychopathological range as the extreme male brain hypothesis (EMB) of ASD would suggest

    Overview of Female and Male Medians (QD) for Slopes and Intercepts of Same and Different Trials.

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    <p><i>Note</i>. <i>QD</i> = Quartile Deviations.</p><p>Overview of Female and Male Medians (QD) for Slopes and Intercepts of Same and Different Trials.</p

    MR accuracy (in percentage), reaction times (in ms) and inverse efficiency scores (RT / accuracy) separately for same and different trials for female (grey triangles) and male (black squares) participants.

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    <p>MR accuracy (in percentage), reaction times (in ms) and inverse efficiency scores (RT / accuracy) separately for same and different trials for female (grey triangles) and male (black squares) participants.</p

    Typical examples of 3D figures used in the current Mental Rotation task.

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    <p>Cognitive processes related to task performance can be divided into independent rotational and non-rotational components. Typical sex differences were observed within the rotational dimension, whereas variation related to diagnosis was observed within the non-rotational dimension.</p

    No Higher Risk-Seeking Tendencies or Altered Self-Estimation in a Social Decision-Making Task in Patients with Parkinson's Disease

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    Background: Parkinson's disease (PD) has been associated with a tendency towards more risky decisions. However, the commonly used paradigms typically neglect the social context. Objective: Here, we investigated social decision-making and self-estimation in a competitive experimental task. Methods: A computerized experimental setting was used in which 86 PD patients (age = 66.5 [50-79], 62.8% male, H&Y= 2 [1.5-3]) and 44 healthy controls (HC; age = 67 [54-79], 54.4% male) in groups of four performed mathematical addition tasks in which they were asked to calculate as many sums as possible in five minutes. Participants had to choose their preferred compensation scheme (piece rate versus tournament) and retrospectively rank their performance in comparison to the suspected performance of the others. A comprehensive neuropsychological test battery was also conducted. Results: No significant difference was found in overall social decision-making and self-estimation between PD patients and HC. However, for those individuals who made inadequate decisions, PD patients engaged in significantly more risk-averse and HC in more risky decisions. Concerning those inadequate decisions, the PD patients made more extreme decisions (severity of social decision-making) in both directions (risk-averse, risk-seeking). Conclusion: Our data indicate that social decision-making behavior and self-estimation are largely intact in PD patients with mild to moderate disease stages and intact global cognition, executive functions, and social cognition. Future studies with more heterogeneous PD samples regarding their neuropsychological profile will have to examine at which state social decision-making may be affected and by which factors this behavior might be influenced

    Erratum to: Methods for evaluating medical tests and biomarkers

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    The original MEMTAB Abstracts in Diagnostic and Prognostic Research contains the incorrect year on individual abstracts in the PDF [1].“Diagnostic and Prognostic Research 2016” under the correspondence line should therefore have been written as “Diagnostic and Prognostic Research 2017” as the journal did not launch until 2017
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