In medicine and statistics, the gold standard test is usually the best available diagnostic or benchmark test under reasonable conditions . At other times, the gold standard is the most accurate test possible without restrictions .
Both meanings are different because for example, in medicine, dealing with conditions that would require an autopsy to have a perfect diagnosis, the gold standard test would be the best that keeps the patient alive rather than autopsy.
Video Gold standard (test)
In medicine
The "gold standard" may refer to the criteria used to assess scientific evidence. For example, in resuscitation studies, the "gold standard" test of a drug or procedure is whether it leads to an increase in the number of neurologically intact survivors who are discharged from the hospital. Other types of medical research may consider a significant decline in 30-day deaths as the gold standard.
The AMA Style Guide prefers the phrase Standard Criteria instead of "gold standard", and many medical journals now mandate this use in their instructions for contributors. For example, Medical Archives and Biological Rehabilitation define this usage. When a criterion is an overall clinical testing procedure it is usually referred to as a clinical case definition.
The ideal hypothetical "gold standard" test has a 100% sensitivity with respect to the presence of the disease (identifies all individuals with well-defined disease processes, has no false-negative results) and 100% specificity (it does not misidentify a person with a condition that has no condition; it does not have false positive results). In practice, sometimes there is no true "gold standard" test.
When new diagnostic methods are available, the "gold standard" test may change over time. For example, for the diagnosis of aortic dissection, the "gold standard" test is used as an aortogram, which has a sensitivity as low as 83% and a specificity as low as 87%. Due to the magnetic resonance imaging advancement, magnetic resonance angiogram (MRA) has become the new "gold standard" test for aortic dissection, with 95% sensitivity and 92% specificity. Before it was widely accepted from each new test, the previous test retained its status as a "gold standard".
Maps Gold standard (test)
Calibration test
Because the test can be false (false-negative or false-positive), the result must be interpreted in the historical context, physical findings, and other test results on the individual being tested. It is in this context that the sensitivity and specificity of the "gold standard" test is determined.
When the gold standard is not perfect, its sensitivity and specificity should be calibrated against more accurate testing or to the definition of conditions. This calibration is essential when perfect tests are available only with autopsies. It is important to emphasize that tests must meet some interobserver agreements, to avoid biases caused by the research itself.
Calibration errors can cause misdiagnosis.
Ambiguity
Sometimes a "gold standard test" refers to the best performing test available. In this case, no other criterion can be compared and that is equivalent to the definition. When referring to this meaning, standard gold tests are usually not done at all. This is because a gold standard test may be difficult or impossible for a living person (ie the test is performed as part of an autopsy or may take too long for a clinically useful test result).
At other times, the "gold standard" does not refer to the best performing test available, but the best is available under reasonable conditions. For example, in this sense, MRI is the gold standard for the diagnosis of brain tumors, although not as good as biopsy. In this case the sensitivity and specificity of the gold standard is not 100% and is said to be "imperfect gold standard" or "gold standard alloy".
The term ground truth refers to the underlying absolute information; the gold standard seeks to represent the basic truth as closely as possible. While the gold standard is the best effort to get the truth, the basic truth is usually collected by direct observation. In machine learning and information retrieval, "ground truth" is a preferred term even when the classification may not be perfect; the gold standard is assumed to be the basic truth .
See also
- Evidence based medicine
- The fundamental truth
- Statistical test
References
Source of the article : Wikipedia
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