Systematic Reviews of Diagnostic Test Accuracy

16 December 2008 | Volume 149 Issue 12 | Pages 889-897

More and more systematic reviews of diagnostic test accuracy studies are being published, but they can be methodologically challenging. In this paper, the authors present some of the recent developments in the methodology for conducting systematic reviews of diagnostic test accuracy studies. Restrictive electronic search filters are discouraged, as is the use of summary quality scores. Methods for meta-analysis should take into account the paired nature of the estimates and their dependence on threshold. Authors of these reviews are advised to use the hierarchical summary receiver-operating characteristic or the bivariate model for the data analysis. Challenges that remain are the poor reporting of original diagnostic test accuracy studies and difficulties with the interpretation of the results of diagnostic test accuracy research.

Author and Article Information

From the Dutch Cochrane Centre and Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Unit of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom; and Center for Statistical Sciences, Brown University, Providence, Rhode Island.

Grant Support: By the UK National Institute for Health Research (grant RNC/018/0003), the National Cancer Institute (grant 2U01CA079778), and the Cochrane Collaboration.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Jonathan J. Deeks, PhD, Unit of Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom; e-mail, j.deeks{at}bham.ac.uk.

Current Author Addresses: Drs. Leeflang and Bossuyt: Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, the Netherlands.

Dr. Deeks: Unit of Public Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom.

Dr. Gatsonis: Center for Statistical Sciences, Brown University, Box G-S121, 121 South Main Street, 7th Floor, Providence, RI 02912.