STEP: improving the evaluation and use of tests for screening, diagnosis and monitoring in healthcare.

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Medical tests - for screening, diagnosis, and monitoring - are often poorly evaluated and poorly used. This program, run by an established team with skills in public health, clinical epidemiology, biostatistics, health economics and behavioural science, addresses the under-researched issues of whether, when and how to use medical tests. The elements of the program follow the sequence in which testing is often done: for screening (early detection), for diagnosis on which to base treatment decisions, and for monitoring the effects of treatment. A common approach throughout is the identification of the benefits and harms of testing and assessing their trade-offs; how benefits weigh up against harms. This research is relevant to all partners in healthcare - consumers, clinicians and policymakers - who currently are being tested or implementing tests without being fully informed about the accuracy and effects of these tests.