This chapter of the Medical Test Methods Guide focuses on choosing strategies for meta-analysis of test “accuracy,” or more preferably, test performance. 1 Generic by their very nature, these challenges and their discussion apply to the larger set of systematic reviews of medical tests, and are not specific to AHRQ's program. The Methods Guide to Medical Test Reviews (also referred to as the Medical Test Methods Guide) highlights common challenges in systematic reviews of medical tests and outlines their mitigation, as perceived by researchers partaking in the Agency for Healthcare Research and Quality (AHRQ) Effective Healthcare Program. This can be performed in the context of proper (multivariate) meta-regressions. At the same time, quantitative analyses are used to explore and explain any observed dissimilarity (heterogeneity) in the results of the examined studies. More complex analyses are needed if studies report results at multiple thresholds for positive tests. Because sensitivity and specificity are not independent across studies, the meta-analysis of medical tests is fundamentally a multivariate problem, and should be addressed with multivariate methods. The choice of the most helpful summary is subjective, and in some cases both summaries provide meaningful and complementary information. Other times, when the sensitivity or specificity estimates vary widely or when the test threshold varies, it is more helpful to synthesize data using a "summary line" that describes how the average sensitivity changes with the average specificity. Sometimes, a helpful way to summarize medical test studies is to provide a "summary point," a summary sensitivity and a summary specificity. Because many metrics of test performance are of interest, the meta-analysis of medical tests is more complex than the meta-analysis of interventions or associations. Synthesizing information on test performance metrics, such as sensitivity, specificity, predictive values and likelihood ratios, is often an important part of a systematic review of a medical test. This guide has been updated to include changes to the report introduced August 22, 2022.This is a chapter from AHRQ's Methods Guide for Medical Test Reviews. The GI-MAP's accuracy and reliability allows practitioners to create personalized treatment protocols to address gut dysfunction based on which infections are urgent, which areas of the gut are already optimized, and which areas should be addressed after an infection is resolved.Īdditionally, the quantification offers a remarkable ability to see how treatment modalities are working because a retest after treatment can show whether a parasite has resolved, dysbiosis has improved, and more. GI-MAP Allows for the Personalized Treatment Plans and Informative Retests To achieve it, we perform rigorous quality control, and have validated all molecular target quantification assays to meet or exceed FDA standards. Reproducibility is of crucial importance to the practitioners and patients that rely on the efficacy of the GI-MAP. The GI-MAP also provides consistently reproducible results. Standard PCR technology doesn't offer the same level of sensitivity, or the ability to express precise numerical results. This technology is used routinely in clinical and academic research because it provides highly-accurate quantification, as well as high levels of sensitivity and specificity. QPCR's Reliability, Reproducibility, and Use in Clinical ResearchĪlthough qPCR is becoming more commonplace in in-vitro diagnostics (IVD), we are the only laboratory in the United States exclusively using qPCR technology for advanced comprehensive stool testing. It relies exclusively on quantitative polymerase chain reaction (qPCR) technology to detect parasites, bacteria, fungi, and more, by targeting the specific DNA of the organisms tested. The GI-MAP (Microbial Assay Plus) is unique in the field of comprehensive stool testing. Assessing GI health with the proper tools can help practitioners get to the root cause of chronic illness. The gut microbiome, in particular, plays a critical role in mediating the effects of diet and other factors on health, including digestive, immune, metabolic and neuroendocrine functions. Research overwhelmingly indicates that gut health impacts overall health. Optimal Health - It All Starts with the GI-MAP ®
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