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Addressing the need for economic modelling when designing and reporting a diagnostic testing accuracy study
Xuanqian Xie1, Jennifer Guo1,2, Jessalyn K Holodinsky3,4,5,6,7
1Acute and Hospital-Based Care, Ontario Health, Toronto, ON, Canada.
Frontiers in Public Health
|January 23, 2026
Summary
This study proposes eight additions to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 guidelines to improve economic evaluations of diagnostic tests. Enhancing STARD reporting increases the credibility of test accuracy data used in economic models.
Area of Science:
- Health economics
- Medical diagnostics
- Biostatistics
Background:
- Model-based economic evaluations are crucial for assessing new diagnostic and prognostic tests.
- Diagnostic test accuracy (DTA) studies provide essential data for these evaluations.
- The Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 are the current gold standard for reporting DTA studies.
Purpose of the Study:
- To identify potential enhancements for the STARD 2015 guidelines.
- To improve the credibility of DTA-based economic evaluations.
- To propose eight new elements for the STARD guidelines.
Main Methods:
- A rapid review of publicly available economic evaluations of new diagnostic tests (2012-2025) was conducted.
- The review focused on identifying elements that could strengthen DTA-based economic evaluations.
- Eight key elements were formulated based on the review findings.
Main Results:
- Eight elements were identified as potential additions to the STARD 2015 guidelines.
- These elements aim to enhance the quality and transparency of DTA reporting for economic evaluations.
- Practical recommendations and examples from the review were provided.
Conclusions:
- The proposed additions can significantly enhance the credibility of DTA-based economic evaluations.
- Incorporating these elements into STARD reporting will improve the reliability of economic assessments for new diagnostic technologies.
- This work offers a pathway to more robust health economic decision-making.
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