RESUMEN
OBJECTIVES: To determine the association between the quality of guidelines for diagnostic tests (both the quality and reporting and the quality of the evidence underpinning recommendations) and nonadherence. STUDY DESIGN AND SETTING: We conducted a meta-epidemiological study. We previously published a systematic review that quantified the percentage of test use that was nonadherent with guidelines. For the present study, we assessed these guidelines using the Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. We then assessed the quality of evidence underpinning recommendations within these guidelines using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Linear models were then constructed to determine the association between guideline nonadherence and (1) AGREE II score and (2) GRADE score. RESULTS: There was no significant association between AGREE II score and nonadherent testing (P = 0.09). There was a significant association between GRADE score and nonadherence: recommendations based on low-quality and very low-quality evidence had 38% (P < 0.01) and 24% (P = 0.02) more nonadherent testing, compared with recommendations based on high-quality evidence. CONCLUSION: Diagnostic test guideline recommendations based on high-quality evidence are adhered to more frequently.
Asunto(s)
Pruebas Diagnósticas de Rutina , Medicina Basada en la Evidencia/métodos , Adhesión a Directriz/estadística & datos numéricos , Guías de Práctica Clínica como Asunto/normas , Pruebas Diagnósticas de Rutina/métodos , Pruebas Diagnósticas de Rutina/normas , Estudios Epidemiológicos , Humanos , Garantía de la Calidad de Atención de Salud , Proyectos de InvestigaciónRESUMEN
The effects of temperature and applied voltage on the pyroelectric properties of an antiferroelectric liquid crystal are given. It has been found that the pyroelectric signal depends strongly on the bias voltage across the sample. The pyroelectric signal behaviour is interpreted with the aid of spontaneous polarization data and good agreement is found between the results from the pyroelectric and polarization techniques. The spontaneous polarization of the sample exhibits the temperature- and field-induced `Devil's staircase' behaviour, as predicted by the Ising model.