Klaringsrapporterne 1996-2001. Lave anförte evidensniveauer for den diagnostiske traefsikkerhed af anbefalede klinisk-biokemiske undersögelser
Sammanfattning
Introduction: Our aim was to investigate the level of evidence presented for the diagnostic accuracy of biochemical tests re-commended for diagnostic use in the Danish clinical guidelines (»Kla-ringsrapporter«) in 1996-2001. We also appraised the use of references in the guidelines. Materials and methods: We examined 54 guidelines in order to make recommendations regarding the diagnostic use of biochemical tests. We then rated the level of evidence presented for the accuracy of diagnosis using an internationally recognized evidence hierarchy. We also noted whether the guidelines presented a list of references and whether it was possible to link statements to specific references. Finally, we examined whether the principle of presenting the reliability of recommendations was applied in the guidelines. Results: Twenty of the guidelines presented 36 recommendations for the diagnostic use of biochemical tests. The level of evidence presented for the tests' diagnostic accuracy was the lowest possible for three fourths of the 36 recommendations. With regard to the general use of references, 5 of the 54 guidelines did not present any references, and references were linked directly with the recommendations in only 34 of the 49 guidelines that provided a list of references. Five of the guidelines applied the principle of presenting the reliability of the recommendations. Discussion: Internationally, there is growing concern about the need to ensure an evidence-based use of diagnostic proced-ures. This study of Danish guidelines confirms that such a problem exists in relation to biochemical tests. However, the general use of references in the guidelines indicates that the level of evidence presented is likely to be insufficient for other recommendations as well.