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Table 2 GRADE evidence for diagnostic accuracy of lumbar disc herniation

From: Diagnostic accuracy of diagnostic imaging for lumbar disc herniation in adults with low back pain or sciatica is unknown; a systematic review

  Study design Indirectness Inconsistency Imprecision Publication bias Quality
 9 studies Serious limitationa Nob Noc Nod Noe Moderate
 8 studies Serious limitationa Nob Noc Nod Noe Moderate
 6 studies Serious limitationa Nob Serious limitationc Serious limitationd Noe Very low
  1. aMore than 25% of participants in studies with two or more high risk of domains among four risk of bias domains
  2. bStudies done in a hospital setting. It was not considered as a serious applicability concern because only surgery was a reference standard
  3. cIt was evaluated by a correlation between logit-transformed sensitivity and logit-transformed specificity. dWide confidence interval of the sensitivity and specificity in more than 25% of the studies
  4. eThe possibility of publication bias is not excluded but it was not considered sufficient to downgrade the quality of evidence