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Reliability and benefit of diagnostic procedure for asthma in young children is unclear
Date:8/20/2009

hen investigated the accuracy of diagnostic procedures without using a reference standard.

No recommendation for diagnostic procedures can be derived from studies

In this second part of the commission, IQWiG investigated how suitable the procedures are in differentiating between those children who have symptoms but do not require long-term treatment and those children who develop chronic asthma. This ability to discriminate and predict is particularly important for those children who might have to be enrolled on a DMP.

After analysing a total of 7 studies available at that time, IQWiG came to the conclusion that the literature could not provide any recommendations for an individual method, or a combination of specific methods, that could be used as a criterion for enrolment on a DMP. The superiority of one test over any other could not be established.

This is firstly because there are only a few clinical comparisons dealing with the commission's research question. Secondly, the data contained in them have no validity, because the study and report quality displayed flaws. For example, there is a lack of data on the severity of disease in the patients examined, yet the degree of severity can have an influence on how reliably the test confirms the disease. The analysed studies indicate that a diagnostic algorithm could be used, i.e. a certain sequence in which individual measures can be combined together.

"Linked evidence" method could not be applied

In order to assess the diagnostic procedures, IQWiG also evaluated their efficacy. The tests can only be described as efficacious if they result in a therapeutic benefit, i.e. the patients can benefit from treatment. However, as the search revealed, there are currently no diagnostic studies that could provide a direct answer to the question of test efficacy (Phase 4 diagnostic studies), because this would require a study design that investigates a treatmen
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Contact: Dr. Anna-Sabine Ernst
info@iqwig.de
49-022-135-6850
Institute for Quality and Efficiency in Health Care
Source:Eurekalert

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