This article presents practical guidelines for conducting systematic reviews of diagnostic studies, developed based on evidence and the expertise of the Cochrane Collaboration. The guidelines are structured in a stepwise manner and include comments for further clarification. They are illustrated with examples from two systematic reviews: one on the accuracy of the urine dipstick in diagnosing urinary tract infections and another on the accuracy of the straight-leg-raising test in diagnosing intervertebral disc hernia. The guidelines cover several key areas: searching for relevant studies, inclusion criteria, methodological quality assessment, data extraction, data analysis, and handling heterogeneity. They emphasize the importance of using a 'gold standard' for evaluating diagnostic tests, ensuring detailed information about the study population, and accurately reporting outcome data. The guidelines also address the challenges of heterogeneity in diagnostic studies and suggest methods for dealing with it, such as subgroup analysis and the use of random effect models for statistical pooling. The article highlights the need for careful consideration of study quality, the potential for bias, and the importance of transparent reporting. It also discusses the limitations of current diagnostic research and the need for further methodological development. The guidelines aim to help researchers conduct systematic reviews that are methodologically sound and provide reliable evidence for clinical decision-making. The authors emphasize the importance of using standardized data extraction forms and ensuring that all relevant studies are included, regardless of language. They also note the challenges of identifying non-English publications and the potential for bias in excluding them. The guidelines are intended to assist researchers in conducting systematic reviews that are both comprehensive and methodologically rigorous.This article presents practical guidelines for conducting systematic reviews of diagnostic studies, developed based on evidence and the expertise of the Cochrane Collaboration. The guidelines are structured in a stepwise manner and include comments for further clarification. They are illustrated with examples from two systematic reviews: one on the accuracy of the urine dipstick in diagnosing urinary tract infections and another on the accuracy of the straight-leg-raising test in diagnosing intervertebral disc hernia. The guidelines cover several key areas: searching for relevant studies, inclusion criteria, methodological quality assessment, data extraction, data analysis, and handling heterogeneity. They emphasize the importance of using a 'gold standard' for evaluating diagnostic tests, ensuring detailed information about the study population, and accurately reporting outcome data. The guidelines also address the challenges of heterogeneity in diagnostic studies and suggest methods for dealing with it, such as subgroup analysis and the use of random effect models for statistical pooling. The article highlights the need for careful consideration of study quality, the potential for bias, and the importance of transparent reporting. It also discusses the limitations of current diagnostic research and the need for further methodological development. The guidelines aim to help researchers conduct systematic reviews that are methodologically sound and provide reliable evidence for clinical decision-making. The authors emphasize the importance of using standardized data extraction forms and ensuring that all relevant studies are included, regardless of language. They also note the challenges of identifying non-English publications and the potential for bias in excluding them. The guidelines are intended to assist researchers in conducting systematic reviews that are both comprehensive and methodologically rigorous.