Evaluating diagnostic tests-should the same methods apply?

摘要

It is now accepted wisdom by regulators, purchasers, journal editors, and clinicians that the true effects of health care interventions can only be evaluated by well-designed randomized controlled trials. The study by Rutten et al, reports the results of a randomized controlled trial of N-terminal pro-brain natriuretic peptide in an emergency department in the Netherlands. Given that this is the third randomized controlled trial assessing the effectiveness and cost-effectiveness of a natriuretic peptide in an emergency department setting, it is important to ask whether diagnostic tests should always be evaluated by randomized controlled trials or are other study types that generate test accuracy data sufficient?#