Adherence wurde nicht berücksichtigt und damit bleibt die Microsimulation und die Ergebnisse im Journal of the National Cancer Institute unberücksichtigt bzw ohne Wertung. Aus reinen sensitivity und specificity Gesichtspunkten kann der Test nicht bestehen. Daher die Ablehnung...
Aus der CMS Begründung: "However, the validation of a screening test does not include an assessment of adherence or compliance with CRC screening guidelines (Cochrane and Holland, 1971). Level 2 diagnostic accuracy efficacy, or test performance characteristics, is defined as sensitivity and specificity in a defined clinical problem setting, not compliance with screening guidelines (Fryback, 1991). Adherence can be measured as participation rates in an organized screening program that complies with a set of CRC screening guidelines or uptake of a screening test (D’Andrea, 2020; Liles, 2017). Adherence or compliance with CRC screening guidelines should not be considered a test performance characteristic of a screening test. In this Analysis, test performance characteristics to evaluate the benefit of a blood based CRC screening test are sensitivity, specificity, and positive predictive value, but not adherence."
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