Evidence map›Paper›PMID 32676897›Full record

Trial reportEuropean radiology experimental2020

Classifying the diagnosis of study participants in clinical trials: a structured and efficient approach.

Tjitske S R van Engelen, Maadrika M N P Kanglie, Inge A H van den Berk, Merel L J Bouwman, Hind J M Suhooli, Sascha L Heckert, Jaap Stoker, Patrick M M Bossuyt, Jan M Prins, OPTIMACT Study Group

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in European radiology experimental, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.7field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Trial
  4. Article
  5. External Validation of the 2023 Duke-International Society for Cardiovascular Infectious Diseases Diagnostic Criteria for Infective Endocarditis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Tjitske S R van EngelenDepartment of Internal Medicine, Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Room: T1-0-240, Amsterdam, The Netherlands. t.s.vanengelen@amsterdamumc.nl.ORCID 0000-0001-6186-2550
Maadrika M N P KanglieDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Inge A H van den BerkDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Merel L J BouwmanDepartment of Internal Medicine, Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Room: T1-0-240, Amsterdam, The Netherlands.
Hind J M SuhooliDepartment of Internal Medicine, Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Room: T1-0-240, Amsterdam, The Netherlands.
Sascha L HeckertDepartment of Internal Medicine, Center for Experimental and Molecular Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Room: T1-0-240, Amsterdam, The Netherlands.
Jaap StokerDepartment of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Patrick M M BossuytDepartment of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Jan M PrinsDepartment of Internal Medicine, Division of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
OPTIMACT Study Group
Amsterdam University Medical Centers · NLAmsterdam Neuroscience · NL

Funding

Universiteit van Amsterdam Innovation GrantZonMw 843001806
6 · The paper itself

Abstract

backgroundA challenge in imaging research is a diagnostic classification of study participants. We hypothesised that a structured approach would be efficient and that classification by medical students, residents, and an expert panel whenever necessary would be as valid as classification of all patients by experts.

methodsOPTIMACT is a randomised trial designed to evaluate the effectiveness of replacing chest x-ray for ultra-low-dose chest computed tomography (CT) at the emergency department. We developed a handbook with diagnostic guidelines and randomly selected 240 cases from 2,418 participants enrolled in OPTIMACT. Each case was independently classified by two medical students and, if they disagreed, by the students and a resident in a consensus meeting. Cases without consensus and cases classified as complex were assessed by a panel of medical specialists. To evaluate the validity, 60 randomly selected cases not referred to the panel by the students and the residents were reassessed by the specialists.

resultsOverall, the students and, if necessary, residents were able to assign a diagnosis in 183 of the 240 cases (76% concordance; 95% confidence interval [CI] 71-82%). We observed agreement between students and residents versus medical specialists in 50/60 cases (83% concordance; 95% CI 74-93%).

conclusionsA structured approach in which study participants are assigned diagnostic labels by assessors with increasing levels of medical experience was an efficient and valid classification method, limiting the workload for medical specialists. We presented a viable option for classifying study participants in large-scale imaging trials (Netherlands National Trial Register number NTR6163).

Indexed as

Clinical CompetenceEmergency Service, HospitalRadiography, ThoracicTomography, X-Ray ComputedAdultFemaleGuidelines as TopicHumansInternship and ResidencyLung DiseasesMaleNetherlandsRadiation DosageStudents, MedicalcomputedEmergency service (hospital)MethodsObserver variationRadiography (thoracic)Tomography x-ray

Identifiers

PMID32676897
PMCPMC7366867
OpenAlexW3043317701

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.