review bias

More on Bias

Here are a few more forms of bias to consider.
Review Bias²
^{Subjective interpretations may be biased
by prior knowledge.}

Test review bias occurs when persons interpreting the test under investigation have knowledge of the gold standard test result
Diagnostic review bias occurs when interpretation of the gold standard test is made with knowledge of the test under investigation or other clinical data.
Incorporation bias occurs when results of the test under study are actually used to make the final diagnosis.

Context Bias
Interpreters are influenced by prior experience or knowledge that the investigators are seeking a particular lesion. If a disease is particularly common in an institution or setting than those interpreting tests will be more likely to judge them as positive or suggestive of this disease. For example, it seems likely that a radiologist working in a largely African American population would interpret x-rays demonstrating hilar adenopathy as suggestive of sarcoidosis more readily than or than a radiologist working in an oncology referral center.

Analysis of cases with indeterminate results
Authors may deal with these cases by considering them as positives, negatives or by excluding them from analysis. Each of these methods will alter the reported test performance. Considering these positive increases sensitivity, considering them negative increases specificity. In any case, frequent indeterminate results diminishes the value of a test.