Selecting statistical methods for meta-analyzing diagnostic accuracy data: an online survey

Article type
Authors
Ochodo E1, Reitsma J2, Bossuyt P1, Leeflang M1
1Academic Medical Centre, University of Amsterdam, The Netherlands
2Utrecht Medical Centre, Utrecht University, The Netherlands
Abstract
Background: Different methods for meta-analyzing diagnostic accuracy data have been proposed and choosing the appropriate methods may be challenging. We asked authors of diagnostic accuracy reviews about selecting the type of methods for meta-analysis of the data in their study.

Methods: We searched MEDLINE for diagnostic accuracy meta-analyses published in English between September 2011 and January 2012. We then designed and pre-tested an online questionnaire using the software SurveyMonkey. This survey was sent to email addresses of corresponding authors of diagnostic accuracy reviews. This survey was run for 1 month ( March 28 to April 28, 2012).

Results: Our search identified 1335 articles of which we selected 100 eligible articles for the survey. Two authors opted out of receiving surveys so the survey was sent to 98 authors. Of these, 42 authors (43%) had used more advanced methods of meta-analysis (hierarchical random effects approach) and 56 authors (57%) used more traditional methods (summary receiver operating characteristic (SROC) or univariate approach). Fifty-seven authors responded to the survey (58% response rate); 29 (51%) used advanced methods of meta-analysis and 28 (49%) used traditional methods. Most authors who used advanced methods reported to do so because the method is currently recommended (n = 27) or because it yields precise estimates (n = 21). Most authors who used traditional methods said they did so because the method was easy to understand (n = 20), yields precise estimates (n = 20), or because it is currently recommended (n = 20).

Conclusions: Although more advanced methods for meta-analysis are recommended by the Cochrane Collaboration, both the advanced-methods author group and the traditional-methods author group responded that the method they used is the method that is ‘currently recommended’. We therefore think that clearer guidance is needed for review authors.