Although the test is reliable, the information it provides does not necessarily affect clinical decision making. If it does not change sufficiently the pre-test probability the added value of the information may be low. E.g there may be routine preoperative lab tests that nobody uses in decision making. Moreover, users´ ability to make a correct diagnosis may depend on their knowledge and ability to interpret the results.
RCT, CT, accuracy studies, before-after studies, interrupted time series, change-in management studies
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