Diagnostic test accuracy reviews 3: Advanced meta-analysis – dealing with heterogeneity and test comparisons

Article type
Authors
Macaskill P1
1Screening and Diagnostic Tests Methods Group, Australia
Abstract
Objectives:

The Cochrane Diagnostic Test Accuracy Working Group has developed a series of workshops addressing guidelines as formulated in the Handbook for Diagnostic Test Accuracy reviews. This workshop aims to: 1. Explain the recommended statistical models used for diagnostic test accuracy meta-analysis and their underlying concepts. 2. Illustrate the methods and their interpretation using examples.

Description:

This workshop will cover advanced statistical methods for the meta-analysis of diagnostic test accuracy studies that report estimates of sensitivity and specificity. We will cover the recommended, commonly used hierarchical models (and the relationship between them): 1. The bivariate model, which focuses on the estimation of a summary estimate of sensitivity and specificity. 2. The Hierarchical Summary ROC model of Rutter and Gatsonis, which focuses on the estimation of a summary ROC curve. Both methods will be illustrated with examples, and the choice of method will be discussed. The use of these models for investigating sources of heterogeneity through the inclusion of study level covariates will be described and discussed. The application of this approach to comparing the performance of alternative tests will also be covered, and the use of RevMan 5 to display results will be illustrated.