Chapter 16 – Systematic Reviews of Diagnostic Accuracy – Systematic Reviews in Health Research

Yemisi Takwoingi, Jonathan J. Deeks

Abstract

Information from various sources, including medical history, clinical and physical examination, imaging, and laboratory tests, may be diagnostic. Systematic reviews of diagnostic accuracy can aid in test selection and interpretation of test results. They may assess the accuracy of a single test or compare two or more tests. The lack of design-related indexing terms hampers the identification of diagnostic accuracy studies. Critical appraisal of studies considers the biases specific to diagnostic accuracy studies. The most commonly used measures of test accuracy are sensitivity and specificity. Due to the correlation between sensitivity and specificity induced by the threshold for defining test positivity, statistical methods for combining study results must allow for this. The choice of a statistical method depends on variation in thresholds across studies and the focus of inference. When thresholds vary between studies, study results are best summarized using a summary curve rather than a summary point. Reporting test accuracy using natural frequencies and visual aids can facilitate understanding, making the reviews more accessible to their target audience.

Corrections

There are currently no corrections for this chapter.

Resources

See practicals below.

Practicals

Datasets and Stata do files for the analyses presented in Chapter 16

Schuetz-2010-Comparative-meta-analysis-of-CT-versus-MRI-in-Stata Download

Kay-2020-Investigation-of-effect-of-age-on-performance-of-Xpert-in-Stata Download

Carvalho-2014-Meta-analysis-of-MDQ-for-bipolar-disorder-in-Stata-1 Download

Datasets Download

Author affiliations

Yemisi Takwoingi

Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK

Jonathan G. Deeks