Study designs of evaluations included in the review
The included studies were diagnostic accuracy studies.
Specific interventions included in the review
Studies were eligible if they compared diagnostic tests read by the same readers twice, once with and once without clinical information. The studies had to use identical conditions apart from the intervention. The included studies assessed the following diagnostic tests: cytology of bronchial washings; radiographs of the chest, abdomen and bones; mammography; and computed tomography of the head. The included studies used actual or constructed clinical information. In the majority of studies the time between readings of tests was several months.
Reference standard test against which the new test was compared
Studies were included if they used any reference standard. The reference standards employed included, for example, clinical, laboratory, surgery and autopsy follow-up, biopsy and final clinical diagnosis (details of the reference standards used in the included studies were tabulated).
Participants included in the review
Inclusion criteria were not specified in terms of the participants. The included studies used multiple readers to read tests from patients with a variety of medical conditions.
Outcomes assessed in the review
The studies had to assess test accuracy in comparison with a reference standard, and report either the sensitivity and specificity or a receiver operating characteristic (ROC) curve. The review used the area under the ROC curve as an outcome.
How were decisions on the relevance of primary studies made?
One reviewer selected studies for inclusion.