Study designs of evaluations included in the review
The general inclusion criteria specified that the studies had to report primary data, include at least 10 participants, and all consecutive patients who fulfilled the study entry criteria had to be included. The studies had to report sufficient information to judge the comparability of case and control groups, use an independent blind comparison with a reference standard, and report that the results of the PET scan did not influence the decision to perform the reference test. The studies also had to provide sufficient detail about the methods used to perform the test to permit replication. Additional criteria specific to the individual review questions were detailed in the report.
Specific interventions included in the review
Studies using fluoro-2-deoxy-D-glucose (FDG), dedicated PET or gamma camera systems adapted with 511 keV coincidence imaging capability were eligible.
The specific criteria stated were:
for NSCLC, the use of FDG whole-body PET, conventional staging including a computed tomography (CT) scan of the chest and abdomen;
for epilepsy, PET prior to surgery (not after); and
for coronary revascularisation, both single-photon emission CT (SPECT) and PET had to be done (or studies restricted to patients negative on SPECT). There was no clear statement about reference standards in the inclusion criteria. There was wide variation in the reference standards used in the individual primary studies. Some details were tabulated in the report.
Reference standard test against which the new test was compared
There was no clear statement about reference standards in the inclusion criteria. There was wide variation in the reference standards used in the individual primary studies. Some details were tabulated in the report.
Participants included in the review
The specific criteria stated were as follows.
NSCLC: patients with known or suspected NSCLC who were candidates for curative surgery after conventional staging investigations.
Melanoma: patients being evaluated for known or suspected metastatic disease, lymph node assessment or high-risk patients.
Glioma: patients with suspected recurrent glioma (not primary).
Colorectal cancer: patients with suspected recurrence based on clinical features, abnormal imaging or abnormal tumour markers.
Epilepsy: patients with epilepsy refractory to medical treatment who were being considered for surgery.
Coronary revascularisation: patients being considered for revascularisation. Those considered on SPECT to have nonviable myocardium, or where viability was uncertain, were of special interest.
Outcomes assessed in the review
Diagnostic accuracy and the impact on clinical decision-making and health outcomes were assessed. Inclusion criteria specific to the individual review questions were detailed in the report.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.