Epidemic and reporting characteristics of diagnostic test accuracy systematic reviews in China

Article type
Authors
Zhang M1, Sun R1, Chong L2, Li XX1, Zhang ZQ3, Chen YL1, Yang KH1
1Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, China 730000
2The First Clinical Medical College, Lanzhou University, China 730000
3School of public health, Lanzhou University, China 730000
Abstract
Background: Our previous study focused on the developments of statistical methods and software of diagnostic test accuracy systematic reviews (DTASRs) in China, but the epidemic and reporting characteristics of Chinese DTA reviews is unknown.

Objectives: To examine the epidemic characteristics and reporting details of DTASRs in China. Methods: We searched four Chinese medical databases, including Chinese Biomedicine Literature Database (CBM), for DTASRs in the end of the Decemeber 2011 using the search terms ‘systematic review’, ‘meta-analysis’, ‘diagnostic’, ‘sensitivity’, ‘specificity’ and ‘accuracy’. A standard Excel form was used to collect data.

Results: There were 198 studies included. The first Chinese DTASR was published in 2003 and 84.3% reviews were published between 2007 and 2011. More than half (59.1%) were published in journals cited by Chinese Science Citation Database (CSCD), but only 22.2% were published in the professional journals of evidence-based medicine. Cancer was the most common category of target disorder (40.9%), with Laboratory (51.5%) being the most frequent category of tests analyzed. The included reviews assessed methodological quality through QUADAS (41.4%), not reported (27.2%) and others (31.4%). The results of included reviews were presented as sensitivity (84.3%), specificity (84.3%), positive predictive value (7.6%), negative predictive value (7.0%), positive likelihood ratio (52.0%), negative likelihood ratio (51.5%), diagnostic odds ratio (55.0%), and summary receiver operating characteristic curves (70.7%). Publication bias assessment, sensitivity analysis, and heterogeneity analysis were conducted in 15.2%, 18.7%, 37.9% reviews, respectively.

Conclusions: Cancer and laboratory diagnosis get the most attention in Chinese DTASRs, sensitivity and specificity, however, remain the preferred methods for analysis. Most Chinese DTASRs do not use QUADAS and few of them assess publication bias, conduct sensitivity analysis or heterogeneity analysis. Increased familiaritywith DTASR methodologies and conducting DTASRs according to the Cochrane Screening and Diagnostic Tests Methods Group’s requirements regarding format may improve research quality.