Diagnostic test accuracy reviews: advanced meta-analysis - dealing with heterogeneity and test comparisons

Article type
Authors
Macaskill P1, Takwoingi Y1
1Screening and Diagnostic Tests Methods Group
Abstract
Objectives:
1. To explain the recommended statistical models used for diagnostic test accuracy (DTA) meta-analysis and the concepts underlying these methods.
2. To illustrate the methods and their interpretation using examples.
Description: This workshop will cover advanced statistical methods for the meta-analysis of studies of DTA that report estimates of sensitivity and specificity. We will cover the recommended, commonly used hierarchical models (and the relationship between them), namely: 1) the bivariate model, which focuses on the estimation of a summary estimate of sensitivity and specificity; and 2) the hierarchical summary receiver operating characteristic (ROC) model of Rutter and Gatsonis, that focuses on the estimation of a summary ROC curve. Both methods will be illustrated by means of examples, and the choice of method will be discussed. The use of these models for: 1) investigating sources of heterogeneity; and 2) comparing the performance of alternative tests through the inclusion of study level covariates will be described and discussed.
This workshop is designed to explain and discuss the concepts and methods covered in the statistics chapter of the Cochrane Handbook for DTA reviews. Examples with accompanying computer output will be used to illustrate key concepts and issues, and also facilitate group discussions. The use of RevMan 5 to display results will also be illustrated.