PubMed · 8885597
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
M M Patterson. 1996. Why is it so difficult?. https://pubmed.ncbi.nlm.nih.gov/8885597/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
This report describes a hierarchical classification system for clinical endpoints in diagnostic technology assessment. The model requires classification of investigative outcomes into 1 of 6 categories, including technical efficacy, diagnostic accuracy efficacy, diagnostic thinking efficacy, therapeutic efficacy, clinical outcome efficacy, and societal efficacy. Evaluations at successive levels indicate a broader understanding of the test's value. The purpose of this classification system is to help readers of the medical literature consider various aspects of test performance, and to identify aspects of a test that require additional investigation. It is also designed to be used as a template for systematic reviews of diagnostic tests. In this review, examples from the medical literature are discussed to highlight important concepts from the hierarchy model and their relevance to emergency medicine.
Physicians have at their disposal a great number of established diagnostic tests, and new ones continue to be developed that are potentially helpful in diagnosing and establishing the prognosis of disease. Many of these tests were either inadequately evaluated or were found, on more careful scrutiny, to be less helpful than first believed. To ensure optimal patient care as well as appropriate use of health care resources, practitioners must be adept in understanding the true efficacy of diagnostic tests that they ask patients to undergo. They must be able to understand the basic language applied in evaluating tests and be able to determine if and when tests are applicable. (J Am Assoc Gynecol Laparosc 6(1):105-112, 1999)
Fluorescence resonance energy transfer (FRET) phenomenon has been applied to a variety of scientific challenges in the past. The potential utility of this biophysical tool will be revisited in the 21st century. The rapid digital signal processing in conjunction with personal computers and the wide use of multicolor laser technology in clinical flow cytometry opened an opportunity for multiplexed assay systems. The concept is very simple. Color-coded microspheres are used as solid-phase matrix for the detection of fluorescent labeled molecules. It is the homogeneous assay methodology in which solid-phase particles behave similarly to the dynamics of a liquid environment. This approach offers a rapid cost-effective technology that harnesses a wide variety of fluorochromes and lasers. With this microsphere technology, the potential applications for clinical flow cytometry in the future are enormous. This new approach of well-established clinically proven methods sets the stage to briefly review the theoretical and practical aspects of FRET technology. The review shows various applications of FRET in research and clinical laboratories. Combination of FRET with monoclonal antibodies resulted in a boom of structural analysis of proteins in solutions and also in biological membranes. Cell surface mapping of cluster of differentiation molecules on immunocompetent cells has gained more and more interest in the last decade. Several examples for biological applications are discussed in detail. FRET can also be used to improve the spectral characteristics of fluorescent dyes and dye combinations, such as the tandem dyes in flow and image cytometry and the FRET primers in DNA sequencing and polymerase chain reactions. The advantages and disadvantages of donor-acceptor dye combinations are evaluated. In addition, the sensitivity of FRET provides the basis for establishing fast, robust, and accurate enzyme assays and immunoassays. Benefits and limitations of FRET-based assays are thoroughly scrutinized. At the end of the paper we review the future of FRET methodology.