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Evans SR, Pennello G, Pantoja-Galicia N, Jiang H, Hujer AM, Hujer KM, Manca C, Hill C, Jacobs MR, Chen L, Patel R, Kreiswirth BN, Bonomo RA. Benefit-risk Evaluation for Diagnostics: A Framework (BED-FRAME). Clin Infect Dis 2016; 63:812-7. [PMID: 27193750 DOI: 10.1093/cid/ciw329] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/12/2016] [Indexed: 11/14/2022] Open
Abstract
The medical community needs systematic and pragmatic approaches for evaluating the benefit-risk trade-offs of diagnostics that assist in medical decision making. Benefit-Risk Evaluation of Diagnostics: A Framework (BED-FRAME) is a strategy for pragmatic evaluation of diagnostics designed to supplement traditional approaches. BED-FRAME evaluates diagnostic yield and addresses 2 key issues: (1) that diagnostic yield depends on prevalence, and (2) that different diagnostic errors carry different clinical consequences. As such, evaluating and comparing diagnostics depends on prevalence and the relative importance of potential errors. BED-FRAME provides a tool for communicating the expected clinical impact of diagnostic application and the expected trade-offs of diagnostic alternatives. BED-FRAME is a useful fundamental supplement to the standard analysis of diagnostic studies that will aid in clinical decision making.
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Affiliation(s)
- Scott R Evans
- Department of Biostatistics Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Gene Pennello
- Division of Biostatistics, Office of Surveillance and Biometrics, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Norberto Pantoja-Galicia
- Division of Biostatistics, Office of Surveillance and Biometrics, Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland
| | - Hongyu Jiang
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Andrea M Hujer
- Louis Stokes Cleveland Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Ohio
| | - Kristine M Hujer
- Louis Stokes Cleveland Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Ohio
| | - Claudia Manca
- Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark
| | - Carol Hill
- Duke Clinical Research Institute, Duke University, Durham, North Carolina
| | - Michael R Jacobs
- Louis Stokes Cleveland Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Ohio
| | - Liang Chen
- Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark
| | | | - Barry N Kreiswirth
- Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark
| | - Robert A Bonomo
- Louis Stokes Cleveland Veterans Affairs Medical Center, Case Western Reserve University School of Medicine, Ohio
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