Res Synth Methods - Methods for the joint meta-analysis of multiple tests.

Tópicos

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Resumo

Existing methods for meta-analysis of diagnostic test accuracy focus primarily on a single index test. We propose models for the joint meta-analysis of studies comparing multiple index tests on the same participants in paired designs. These models respect the grouping of data by studies, account for the within-study correlation between the tests' true-positive rates (TPRs) and between their false-positive rates (FPRs) (induced because tests are applied to the same participants), and allow for between-study correlations between TPRs and FPRs (such as those induced by threshold effects). We estimate models in the Bayesian setting. We demonstrate using a meta-analysis of screening for Down syndrome with two tests: shortened humerus (arm bone), and shortened femur (thigh bone). Separate and joint meta-analyses yielded similar TPR and FPR estimates. For example, the summary TPR for a shortened humerus was 35.3% (95% credible interval (CrI): 26.9, 41.8%) versus 37.9% (27.7, 50.3%) with joint versus separate meta-analysis. Joint meta-analysis is more efficient when calculating comparative accuracy: the difference in the summary TPRs was 0.0% (-8.9, 9.5%; TPR higher for shortened humerus) with joint versus 2.6% (-14.7, 19.8%) with separate meta-analyses. Simulation and empirical analyses are needed to refine the role of the proposed methodology.

Resumo Limpo

exist method metaanalysi diagnost test accuraci focus primarili singl index test propos model joint metaanalysi studi compar multipl index test particip pair design model respect group data studi account withinstudi correl test trueposit rate tprs falseposit rate fprs induc test appli particip allow betweenstudi correl tprs fprs induc threshold effect estim model bayesian set demonstr use metaanalysi screen syndrom two test shorten humerus arm bone shorten femur thigh bone separ joint metaanalys yield similar tpr fpr estim exampl summari tpr shorten humerus credibl interv cri versus joint versus separ metaanalysi joint metaanalysi effici calcul compar accuraci differ summari tprs tpr higher shorten humerus joint versus separ metaanalys simul empir analys need refin role propos methodolog

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