The article explains the use of stratum-specific likelihood ratios(SSLRs) and the use of a checklist for critically appraising articles on diagnostic tests. The author recommends the use of SSLRs over sensitivity/specificity when evaluating the test characteristics of a given test, because the former retains as much information as possible of the test. Critical appraisal of a diagnostic test forms a part of the practice of evidence-based medicine(EBM). The particular importance of paying attention to work-up bias and spectrum bias when evaluating a diagnostic test is emphasized. It is hoped that future studies in laboratory medicine will follow these guidelines.

*Department of Psychiatry, Nagoya City University, Medical School, Nagoya 467-8601