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A description of the primary studies of diagnostic test accuracy indexed in DiTA

In 2019 the team behind PEDro launched a new database, called DiTA (Diagnostic Test Accuracy; dita.org.au). DiTA is modelled on PEDro and provides a comprehensive index of studies and reviews evaluating the accuracy of diagnostic tests used by physiotherapists. The intention is that DiTA will help physiotherapists and others use research evidence to select and inform the interpretation of diagnostic tests.

A recent study provides an overview of how DiTA is constructed and describes the number and scope of the studies indexed in DiTA. Sensitive searches are conducted to identify studies and reviews that evaluate the accuracy of diagnostic tests used by physiotherapists. Medline, Embase, CINAHL and the Cochrane Database of Systematic Reviews were searched from their inceptions, and monthly searches are now used to update DiTA. To be included in DiTA, studies need to (a) investigate both a pathology and patients that a physiotherapist could assess in clinical practice, (b) investigate an index test that a physiotherapist would perform themselves (rather than one which they would request), (c) investigate the concordance of an index test with a reference standard, and (d) be published in full in a peer-reviewed journal. Reviews must (a) contain a Methods section that describes the search strategy and inclusion criteria, (b) include at least one study or review that satisfies the criteria for inclusion on DiTA, and (c) be published in full in a peer-reviewed journal. Two reviewers determine eligibility for indexing in DiTA, with disagreements resolved by discussion or arbitration by a third reviewer. The citation (authors, title, journal name, publication date, volume, number, pages, and abstract) are added to DiTA. Additional search terms are applied to each article to define the area of practice (subdiscipline), body part, pathology, index test (both name and type), and reference test (again, both name and type).

As at 1 February 2020, DiTA included 1,419 articles reporting the results of diagnostic test accuracy studies. The most frequently studied subdisciplines were ‘musculoskeletal’ (74%) and ‘cardiothoracics’ (17%). The most frequently studied pathologies involved joints (33%) and the nervous system (12%). The most frequently studied body part was the ‘lower leg or knee’ (16%). Most studies investigated index tests that were ‘physical examination’ procedures (60%), while fewer investigated ‘questionnaires’ (30%) and ‘health technologies’ (25%). The reference standard categories of ‘health technology’ (63%), ‘physical examination’ (20%) and ‘surgery’ (16%) were the most often reported.

There is a rapidly growing body of evidence on the accuracy of diagnostic tests relevant to most physiotherapy subdisciplines. These types of studies are rapidly becoming more prevalent. While the volume of evidence is substantial, it is not yet clear how much of the evidence is of good enough quality to support clinical decision-making. We believe that gathering together all of the available diagnostic test accuracy studies and reviews into one database will make it easier for physiotherapists to rapidly access information on diagnostic tests relevant to their patients, and we believe that this is both important and likely to improve clinical practice.

Kaizik M, et al. A description of the primary studies of diagnostic test accuracy indexed on the DiTA database. Physiother Res Int 2020 Sep 11;Epub ahead of print

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