<![CDATA[This review examines Four-Tier Diagnostic Tests (FTDTs) in physics education, focusing on purposes, designs, models, scoring, measurement evidence, administration modes, and conceptual-change roles. Following PRISMA, Scopus and ERIC were searched for empirical studies published between 2021 and 2025. The final corpus comprised 23 studies: 14 journal articles and nine conference papers. Data were analyzed using descriptive statistics and framework-based narrative synthesis. Eleven studies used classical FTDTs, seven used response-enhanced FTDTs, and five used analytically advanced FTDTs. Most retained the answer–confidence–reason–confidence structure. In contrast, others added open or semi-open reasoning, scaled confidence, mental-model analysis, Rasch or Partial Credit Model scoring, and cognitive diagnostic modeling. Rule-based categorical diagnosis was the most common scoring approach. Among nine development studies, content review and reliability were common, but classification accuracy, fairness, and cross-context stability were limited. Research focused mainly on senior high school, especially mechanics and fluids. Paper-based administration was the most common single mode, although digital formats were also common. FTDTs primarily supported diagnostic profiling and intervention evaluation, whereas fewer studies examined patterns of conceptual change. No study clearly used individual profiles to adapt instruction. FTDT research has progressed toward richer responses, advanced scoring, and conceptual-change evaluation. Future studies should strengthen measurement evidence, standardize scoring, expand cross-context validation, and develop digital systems that link diagnosis to targeted remediation, monitoring, and sustained instructional support. Keywords: four-tier diagnostic test, physics education, misconceptions, diagnostic assessment, conceptual change.]]>
