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Wednesday, September 21, 2011

Gold Standards in Medical Field

What is a 'gold standard'?
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The term 'gold standard' can be referred to a test or a method. A test which shows the true status of the patient is termed gold standard. These test are assumed to have 100% sensitivity and specificity. Diagnostic power of other tests are evaluated based on the comparison with the gold standard test.When the term applies to a method or a procedure, a 'gold standard' serves as a basis for evaluation
of other methods.

Gold standard method for estimating resting energy expenditure - indirect calorimetry

Gold standard investigation for diagnosis of Iron deficiency anemia – Estimation of serum Ferritin

Gold standard for proving that the life span of red cell is decreased ( useful in Hemolytic anemia) - Red cell survival study

Gold standard for evaluation of stem cell transplantation therapy - Hemopoietic stem cell transplantation

Gold standard technique for differentiating allograft rejection and reactivation of disease after heart transplantation - Endo-myocardial Biopsy

Gold standard investigation for diagnosis of DVT - Contrast Venography

Gold standard investigation for diagnosis of acute pharyngitis - Throat Culture

Gold standard investigation for diagnosis of pertussis - Culture of nasopharyngeal secretions

Gold standard investigation for diagnosis of Otitis externa caused by P. aeruginosa - Technetium99 bone scan

Gold standard investigation for diagnosis of Acoustic Neuroma – Gadolinium MRI

Gold standard investigation for diagnosis of Shigella infection - Isolation and identification of pathogen from fecal material

Gold standard investigation for diagnosis of Tuberculous meningitis - Culture of CSF

Gold standard investigation for diagnosis of HSV Encephalitis - Brain biopsy (CSF PCR largely replaced brain biopsy in recent times)

Gold standard investigation for diagnosis of histoplasmosis - Fungal Culture

Gold standard investigation for diagnosis of hypertrophic cardiomypathy and atrial myxoma - Echocardiogram

Gold standard investigation for imaging heart valves and valve motion abnormalities - 2D echocardiography

Gold standard investigation for assessment of Myocardial viability (Identification of ischemic or hibernating myocardium)– PET

Gold standard investigation for assessment of LV mass and volume - MRI

Gold standard method for evaluation of renal arteries and identification of renal artery lesions - Contrast arteriography

Gold standard method for evaluation of respiratory gas exchange - ABG

Gold standard investigation for assessment of albuminuria - 24 hr urine collection

Gold standard investigation for diagnosis of PNH (Paroxysmal Nocturnal Haemoglobinuria) – Flow cytometry

Gold standard investigation for diagnosis of ATTR and other AF mutations - DNA sequencing

Gold standard method for identifying and quantifying atherosclerosis in cerebral arteries - X-ray cerebral angiography

Gold standard investigation for evaluating anatomy of arterio-venous malformation - X-ray angiography

Gold standard for diagnosis and classification of ataxia - genotype

Gold standard investigation for diagnosis of of lung infection (Radiotherapy induced) in a cancer patient - open-lung biopsy

Gold standard medical treatment for symptomatic progressive pulmonary hypertension – Prostacyclin

Gold standard investigation for diagnosis of PIH – Serum Urea

Gold standard for assessment of visual impairment - Snellen's chart

Gold standard method of treatment of non-castrate metastatic disease - surgical orchidectomy

Gold standard method for bacterial stain analysis - Pulse-field gel electrophoresis

Gold standard method of treatment of DCIS - Mastectomy

Gold standard approach for resection of anterior and middle mediastinal masses - median or lateral thoracotomy

Gold standard method of treatment of Coarctation of aorta - Surgical repair

Gold standard method for evaluation of coronary artery disease - Cardiac Catheterization

Gold standard method for culture of V. cholerae o139 - Conventional culture method

Gold standard to determine cut-off titer of widal test for diagnosis of Typhoid fever – Nested PCR

Gold standard treatment of brucellosis in adults - IM Streptomycin + Doxycyclin

Gold standard investigation for diagnosis of of chronic arterial mesentric ischemia - Angiography

Gold standard method for treatment of chronic ulcerative colitis - Total proctocolostomy with end ileostomy

Gold standard method for evaluation of imaging modalities for liver tumors - Intraoperative ultrasonography

Gold standard investigation for diagnosis of common bile duct stones - Endoscopic cholangiography

Gold standard investigation for measurement of GFR - Inulin clearance

Gold standard for treatment of organ confined, muscle invasive, bladder cancer is - Radical cystoprostatectomy in men and anterior pelvic exenteration in woman


Gold standard for treatment of femoral shaft fractures - Reamed locked intramedullary nailing

Gold standard method in case of difficult intubation - Flexible fibreoptic intubation scope

Gold standard method for diagnosis and treatment of Ventilator Associated Pneumonia (VAP) - Broncho alveolar lavage

Gold standard treatment of hyperparathyroidism - Surgery

Gold standard investigation to differentiate follicular and papillary carcinoma of thyroid gland- Histology

Gold standard procedure for thymectomy - Trans cervical mediastinoscopy and surgery

Gold standard for treatment of adrenal tumors - Laparoscopic adrenalectomy

Gold standard investigation for diagnosis of breast cancer - Mammography

Gold standard method for staging of breast cancer - Axillary lymph node dissection

Gold standard for evaluation of a stable patient with suspected vascular injury - Angiography

Gold standard investigation for diagnosis of GERD - Ambulatory 24 hr PH monitoring

Gold standard method for treatment of GERD - Laparoccopic Nissens fundoplication

Gold standard for evaluating cure rate in duodenal ulcer patients – Vagotomy

 Gold standard finding for the diagnosis of GI perforation - Finding pneumoperitoneum

Gold standard for diagnosis of Zollinger-Ellison syndrome - Serum gastrin levels( Most patients have serum gastrin levels above 1000pg/mL)

Gold standard investigation for diagnosis of colonic mucosal disease - Colonoscopy

Gold standard investigation for diagnosis of steatorrhoea - Timed quantitative stool fat determination

Gold standard method for treatment of incontinence with an isolated sphincter defect - Overlapping sphincteroplasty

Gold standard investigation for diagnosis and method of management of Acute arterial occlusion – Laparotomy

Gold standard method for confirmation of mesentric arterial occlusion - Mesentric angiography

Gold standard investigation for diagnosis of celiac disease – Small intestine biopsy

Gold standard for identifying choledocholithiasis – ERCP

Gold standard method of treatment of Symptomatic cholelitiasis – Lap cholecystectomy

Gold standard method for diagnosis of Primary sclerosing cholangitis - ERCP

Gold standard investigation for diagnosis of Hepatitis C – HCV RNA assay

Gold standard test for diagnosis of intraluminal bile duct abnormalities - ERCP

Gold standard method for management of hydatid disease – Surgery

Gold standard for assessing degree of liver injury and fibrosis - Liver Biopsy

Gold standard method for management of blunt hepatic trauma - Non-operative management

Gold standard test for assessment of function of sphincter of oddi – Manometry

Gold standard investigation of diagnosis of Klatskin tumor - Cholangiography

Gold standard investigation for diagnosis of invasive amoebiasis - ELISA

REFERENCES

1. Harrison's principles of Internal Medicine 17th Edition

2. Schwartz's Manual of Surgery 8th Edition

Download the list of Gold standards in PDF format here

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