Systematic reviews of diagnostic test accuracy

Area of Science:

• Medical Research Methodology
• Diagnostic Test Evaluation
• Evidence Synthesis

Background:

• Systematic reviews of diagnostic test accuracy studies are increasing but face methodological challenges.
• Current practices often include suboptimal approaches like restrictive search filters and summary quality scores.

Purpose of the Study:

• To present recent methodological developments for conducting systematic reviews of diagnostic test accuracy studies.
• To guide researchers on best practices for meta-analysis and data interpretation in this field.

Main Methods:

• Discouraging the use of restrictive electronic search filters and summary quality scores.
• Recommending meta-analysis methods that account for paired estimates and threshold dependence.
• Suggesting the hierarchical summary receiver-operating characteristic (HSROC) or bivariate model for data analysis.

Main Results:

• Methodological advancements offer improved approaches to systematic reviews of diagnostic accuracy.
• The HSROC and bivariate models provide robust frameworks for meta-analysis of diagnostic test data.
• Addressing challenges in reporting and interpretation remains crucial for advancing the field.

Conclusions:

• Adoption of recommended methodologies can enhance the quality and reliability of diagnostic accuracy reviews.
• Continued efforts are needed to improve the reporting standards of primary diagnostic accuracy studies.
• Better interpretation guidelines are essential for translating research findings into clinical practice.