Table 3 Example of the target condition and diagnostic test in a clinical example and CPG scenario. The CPG scenario is based on considerations and signals found in our literature search, however, modified for illustrative purposes

Objective

To detect whether there is arterial hypertension

To detect whether a recommendation is outdated

Target condition definition

We consider high blood pressure to be prevalent when there is at least 140 mmHg systolic arterial pressure over 90 mmHg diastolic arterial pressure

We consider the recommendation to be outdated when at least one new relevant peer-reviewed article is published after the previous search date

Detection variable

Pressure on artery walls

New available evidence

Detection test

Auscultatory sphygmomanometer

Literature search in MEDLINE

Detection test protocol

Three blood pressure measurements are taken one to two minutes apart after the patient is seated in a quiet environment for five minutes. The last two blood pressure measurements are averaged

A sensitive search string for MEDLINE is constructed. Search results are screened on title and abstracts by two independent assessors. Conflicts are resolved by a third independent assessor. The resulting potentially relevant articles are read and selected by two assessors independently based on the full text. A third assessor resolves any conflict in the full text selection

Detection test threshold

140 mmHg systolic arterial pressure over 90 mmHg diastolic arterial pressure

Any new peer-reviewed scientific article published after the previous search date