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Simulated changes in systematic review screening sensitivity and specificity associated with varying co-screening
Shaun Prentice1,2, Ben Mundy2, Caitlin Prentice3
1School of Psychology, College of Education, Behavioural and Social Sciences, Adelaide University, Adelaide, SA, Australia.
Co-screening a portion of records in systematic reviews maintains high accuracy. Varying the proportion of co-screening did not significantly impact sensitivity or specificity, suggesting efficiency gains are possible.
Area of Science:
- Bibliometrics and Information Science
- Medical Research Methodology
Background:
- Increasing literature volume necessitates efficient systematic review processes.
- Current guidelines recommend dual-screening all records, but the impact of co-screening subsets on accuracy is less understood.
- This study investigates efficiency gains in systematic reviews without compromising rigor.
Purpose of the Study:
- To evaluate how sensitivity and specificity of title/abstract screening change with varying proportions of co-screened records.
- To determine the impact of different co-screening strategies (dual vs. 3-way) on screening accuracy.
- To identify optimal screening strategies for efficient and accurate systematic reviews.
Main Methods:
- Eight reviewers independently screened 3891 records from a published systematic review.
- Simulations generated dual- and 3-way screening permutations, varying the proportion of co-screened records in 5% increments.
- Screening decisions were compared to full-text decisions to calculate sensitivity and specificity using linear mixed-effects models.
Main Results:
- Sensitivity (median 93.3%-96.3%) and specificity (median 87.7%-89.6%) remained stable across varied co-screening proportions in both dual- and 3-way strategies.
- Higher sensitivity was observed when at least one reviewer possessed subject matter expertise.
- Higher specificity was noted when the primary reviewer had systematic review experience.
Conclusions:
- Complete co-screening of all records does not significantly improve sensitivity or specificity.
- Even low levels of co-screening in dual- and 3-way strategies yield high accuracy.
- Reviewer expertise in subject matter and systematic review conduct influences accuracy, suggesting proportional co-screening enhances efficiency.
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