A diagnostic study is biased when the test being evaluated is also used to help define the diagnosis it's tested against.
Incorporation bias occurs in diagnostic accuracy studies when the results of the index test are used, in whole or in part, to establish the reference standard ('gold standard') diagnosis against which that same test is then judged. This creates a circularity that artificially inflates the test's apparent sensitivity and specificity. Clinicians should check whether the index test was excluded from reference-standard adjudication before trusting reported accuracy figures.
This guide was auto-drafted and is pending editorial review.