Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation?

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Abstract

Objective

To determine the rate with which diagnostic test accuracy studies that are published in a general radiology journal adhere to the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015, and to explore the relationship between adherence rate and citation rate while avoiding confounding by journal factors.

Materials and Methods

All eligible diagnostic test accuracy studies that were published in the Korean Journal of Radiology in 2011–2015 were identified. Five reviewers assessed each article for yes/no compliance with 27 of the 30 STARD 2015 checklist items (items 28, 29, and 30 were excluded). The total STARD score (number of fulfilled STARD items) was calculated. The score of the 15 STARD items that related directly to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 was also calculated. The number of times each article was cited (as indicated by the Web of Science) after publication until March 2016 and the article exposure time (time in months between publication and March 2016) were extracted.

Results

Sixty-three articles were analyzed. The mean (range) total and QUADAS-2-related STARD scores were 20.0 (14.5–25) and 11.4 (7–15), respectively. The mean citation number was 4 (0–21). Citation number did not associate significantly with either STARD score after accounting for exposure time (total score: correlation coefficient = 0.154, p = 0.232; QUADAS-2-related score: correlation coefficient = 0.143, p = 0.266).

Conclusion

The degree of adherence to STARD 2015 was moderate for this journal, indicating that there is room for improvement. When adjusted for exposure time, the degree of adherence did not affect the citation rate.

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Most cited references 76

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Case-control and two-gate designs in diagnostic accuracy studies.

Anne Rutjes, Johannes Reitsma, Jan P. Vandenbroucke … (2005)

In some diagnostic accuracy studies, the test results of a series of patients with an established diagnosis are compared with those of a control group. Such case-control designs are intuitively appealing, but they have also been criticized for leading to inflated estimates of accuracy. We discuss similarities and differences between diagnostic and etiologic case-control studies, as well as the mechanisms that can lead to variation in estimates of diagnostic accuracy in studies with separate sampling schemes ("gates") for diseased (cases) and nondiseased individuals (controls). Diagnostic accuracy studies are cross-sectional and descriptive in nature. Etiologic case-control studies aim to quantify the effect of potential causal exposures on disease occurrence, which inherently involves a time window between exposure and disease occurrence. Researchers and readers should be aware of spectrum effects in diagnostic case-control studies as a result of the restricted sampling of cases and/or controls, which can lead to changes in estimates of diagnostic accuracy. These spectrum effects may be advantageous in the early investigation of a new diagnostic test, but for an overall evaluation of the clinical performance of a test, case-control studies should closely mimic cross-sectional diagnostic studies. As the accuracy of a test is likely to vary across subgroups of patients, researchers and clinicians might carefully consider the potential for spectrum effects in all designs and analyses, particularly in diagnostic accuracy studies with differential sampling schemes for diseased (cases) and nondiseased individuals (controls).

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Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD Initiative.

Patrick Bossuyt, Johannes Reitsma, David Bruns … (2003)

To improve the accuracy and completeness of reporting of studies of diagnostic accuracy, to allow readers to assess the potential for bias in the study and to evaluate its generalisability. The Standards for Reporting of Diagnostic Accuracy (STARD) steering group searched the literature to identify publications on the appropriate conduct and reporting of diagnostic studies and extracted potential items into an extensive list. Researchers, editors, and members of professional organisations shortened this list during a two-day consensus meeting with the goal of developing a checklist and a generic flow diagram for studies of diagnostic accuracy. The search for published guidelines regarding diagnostic research yielded 33 previously published checklists, from which we extracted a list of 75 potential items. At the consensus meeting, participants shortened the list to a 25-item checklist, using evidence, whenever available. A prototypical flow diagram provides information about the method of patient recruitment, the order of test execution and the numbers of patients undergoing the test under evaluation, the reference standard or both. Evaluation of research depends on complete and accurate reporting. If medical journals adopt the checklist and the flow diagram, the quality of reporting of studies of diagnostic accuracy should improve to the advantage of the clinicians, researchers, reviewers, journals, and the public. Copyright RSNA, 2003

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Assessment of the accuracy of diagnostic tests: the cross-sectional study.

Jettie Muris, Bart Knottnerus (2003)

In diagnostic accuracy studies, the contrast of interest can be one of the following: one single test contrast; comparing two or more single tests; further testing in addition to previous diagnostics; and comparing alternative diagnostic strategies. The clinical diagnostic problem under study must be specified. Studies of "extreme contrasts" (as early phase evaluations) and studies in "clinical practice" settings (assessing clinical value) should be distinguished. Design options are (1) survey of the total study population, (2) case-referent approach, or (3) test-based enrollment. Data collection should generally be prospective, but ambispective and retrospective approaches are sometimes appropriate. In addition to determinants of primary interest [the test(s) under study] possible modifiers of test accuracy and confounding variables must be specified. The reference standard procedure should be independent from the test results. Applying a reference standard can be difficult in case of classification errors, lack of a clear pathophysiologic concept, incorporation bias, or invasive or complex investigations. Possible solutions are: an independent expert panel, and the delayed type cross-sectional study (clinical follow-up). Also, a prognostic criterion can be chosen. For studies to be relevant for practice, inclusion criteria must be based on "intention to diagnose" or "intention to screen." The recruitment procedure is preferably a consecutive series of presenting patients or a target population screening, respectively. Sample size estimation should be routine. Analysis has to be focused on the contrast of interest. Estimating test accuracy and prediction of outcome need different approaches. External (clinical) validation requires repeated studies in other, similar populations. Also, systematic reviews and meta-analysis have a role. To enable readers of diagnostic research reports to evaluate whether methodological key issues were addressed, authors are advised to follow the STARD guidelines.

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Author and article information

Journal

Journal ID (nlm-ta): Korean J Radiol

Journal ID (iso-abbrev): Korean J Radiol

Journal ID (publisher-id): KJR

Title: Korean Journal of Radiology

Publisher: The Korean Society of Radiology

ISSN (Print): 1229-6929

ISSN (Electronic): 2005-8330

Publication date (Print): Sep-Oct 2016

Publication date (Electronic): 23 August 2016

Volume: 17

Issue: 5

Pages: 706-714

Affiliations

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.

Author notes

Corresponding author: Seong Ho Park, MD, PhD, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea. Tel: (822) 3010-5984, Fax: (822) 476-4719, parksh.radiology@ 123456gmail.com

Article

DOI: 10.3348/kjr.2016.17.5.706

PMC ID: 5007397

SO-VID: c38308a9-9425-480e-b4e5-be40fe98c06b

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Does the Reporting Quality of Diagnostic Test Accuracy Studies, as Defined by STARD 2015, Affect Citation?

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Abstract

Objective

Materials and Methods

Results

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Scholarly Publication Practices and Impact Factor Calculation and Manipulation

Most cited references 76

Case-control and two-gate designs in diagnostic accuracy studies.

Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD Initiative.

Assessment of the accuracy of diagnostic tests: the cross-sectional study.

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