A conceptual framework (Cat-4) for estimating clinical relevance of evidence related to oral diagnosis

Abstract

This article categorizes studies that assess diagnosis in oral health care into four categories (Cat-4) based on the extent of clinically relevant information in its reported analyses. Category 1 includes studies publishing results from in vitro research. Category 2 includes studies that compare the test results of a diagnostic test of interest versus those of a reference test. Category 3 includes studies that assess the overall effect of the diagnostic test on future health, function, or quality of life. Finally, Category 4 includes studies that report economic analyses. Each category also includes a hierarchy of evidence (based on study design) that can be used for further assessment of internal validity along with other published criteria for testing internal validity and applicability. Clinical application of Cat-4 should result in greater awareness of the uncertainties in diagnosis that can result in missed diagnosis and overdiagnosis.