Temporal dimension in reference standard misclassification - a concept note.

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In situations of diagnostic tests studies where the gold standard (GS ) test is not absolutely perfect , validity measures of index tests vary in subgroups with varying disease prevalence . This is called reference standard misclassification . Although this is widely known , little is explained about the variations in the performance of index tests when the validity of the GS test itself varies with the time duration of illness . This article attempts to expand the concept of reference standard misclassification specifically on the effect of time dependence of diagnostic tests . A brief literature review is also presented which documents the existent knowledge among researchers about the concept and the methods they usually employ to adjust . A list of solutions which can address the issue has also been discussed to enable researchers to design and analyse diagnostic test studies in better ways .