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      Recommendations for reporting of systematic reviews and meta-analyses of diagnostic test accuracy: a systematic review

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          Abstract

          Background

          This study is to perform a systematic review of existing guidance on quality of reporting and methodology for systematic reviews of diagnostic test accuracy (DTA) in order to compile a list of potential items that might be included in a reporting guideline for such reviews: Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA).

          Methods

          Study protocol published on EQUATOR website. Articles in full text or abstract form that reported on any aspect of reporting systematic reviews of diagnostic test accuracy were eligible for inclusion. We used the Ovid platform to search Ovid MEDLINE®, Ovid MEDLINE® In-Process & Other Non-Indexed Citations and Embase Classic+Embase through May 5, 2016. The Cochrane Methodology Register in the Cochrane Library (Wiley version) was also searched. Title and abstract screening followed by full-text screening of all search results was performed independently by two investigators. Guideline organization websites, published guidance statements, and the Cochrane Handbook for Diagnostic Test Accuracy were also searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Standards for Reporting Diagnostic Accuracy (STARD) were assessed independently by two investigators for relevant items.

          Results

          The literature searched yielded 6967 results; 386 were included after title and abstract screening and 203 after full-text screening. After reviewing the existing literature and guidance documents, a preliminary list of 64 items was compiled into the following categories: title (three items); introduction (two items); methods (35 items); results (13 items); discussion (nine items), and disclosure (two items).

          Conclusion

          Items on the methods and reporting of DTA systematic reviews in the present systematic review will provide a basis for generating a PRISMA extension for DTA systematic reviews.

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          Most cited references20

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          External Validation of a Measurement Tool to Assess Systematic Reviews (AMSTAR)

          Beverley Shea, Lex Bouter, Joan Peterson … (2007)
          Background Thousands of systematic reviews have been conducted in all areas of health care. However, the methodological quality of these reviews is variable and should routinely be appraised. AMSTAR is a measurement tool to assess systematic reviews. Methodology AMSTAR was used to appraise 42 reviews focusing on therapies to treat gastro-esophageal reflux disease, peptic ulcer disease, and other acid-related diseases. Two assessors applied the AMSTAR to each review. Two other assessors, plus a clinician and/or methodologist applied a global assessment to each review independently. Conclusions The sample of 42 reviews covered a wide range of methodological quality. The overall scores on AMSTAR ranged from 0 to 10 (out of a maximum of 11) with a mean of 4.6 (95% CI: 3.7 to 5.6) and median 4.0 (range 2.0 to 6.0). The inter-observer agreement of the individual items ranged from moderate to almost perfect agreement. Nine items scored a kappa of >0.75 (95% CI: 0.55 to 0.96). The reliability of the total AMSTAR score was excellent: kappa 0.84 (95% CI: 0.67 to 1.00) and Pearson's R 0.96 (95% CI: 0.92 to 0.98). The overall scores for the global assessment ranged from 2 to 7 (out of a maximum score of 7) with a mean of 4.43 (95% CI: 3.6 to 5.3) and median 4.0 (range 2.25 to 5.75). The agreement was lower with a kappa of 0.63 (95% CI: 0.40 to 0.88). Construct validity was shown by AMSTAR convergence with the results of the global assessment: Pearson's R 0.72 (95% CI: 0.53 to 0.84). For the AMSTAR total score, the limits of agreement were −0.19±1.38. This translates to a minimum detectable difference between reviews of 0.64 ‘AMSTAR points’. Further validation of AMSTAR is needed to assess its validity, reliability and perceived utility by appraisers and end users of reviews across a broader range of systematic reviews.
          Article 0 comments Cited 196 times – based on 0 reviews     Review now
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            Variation of a test's sensitivity and specificity with disease prevalence.

            Patrick Bossuyt, Anne Rutjes, Lotty Hooft … (2013)
            Anecdotal evidence suggests that the sensitivity and specificity of a diagnostic test may vary with disease prevalence. Our objective was to investigate the associations between disease prevalence and test sensitivity and specificity using studies of diagnostic accuracy. We used data from 23 meta-analyses, each of which included 10-39 studies (416 total). The median prevalence per review ranged from 1% to 77%. We evaluated the effects of prevalence on sensitivity and specificity using a bivariate random-effects model for each meta-analysis, with prevalence as a covariate. We estimated the overall effect of prevalence by pooling the effects using the inverse variance method. Within a given review, a change in prevalence from the lowest to highest value resulted in a corresponding change in sensitivity or specificity from 0 to 40 percentage points. This effect was statistically significant (p < 0.05) for either sensitivity or specificity in 8 meta-analyses (35%). Overall, specificity tended to be lower with higher disease prevalence; there was no such systematic effect for sensitivity. The sensitivity and specificity of a test often vary with disease prevalence; this effect is likely to be the result of mechanisms, such as patient spectrum, that affect prevalence, sensitivity and specificity. Because it may be difficult to identify such mechanisms, clinicians should use prevalence as a guide when selecting studies that most closely match their situation.
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              Increasing value and reducing waste in biomedical research: who's listening?

              David Moher, Paul Glasziou, Iain W. Chalmers … (2016)
              The biomedical research complex has been estimated to consume almost a quarter of a trillion US dollars every year. Unfortunately, evidence suggests that a high proportion of this sum is avoidably wasted. In 2014, The Lancet published a series of five reviews showing how dividends from the investment in research might be increased from the relevance and priorities of the questions being asked, to how the research is designed, conducted, and reported. 17 recommendations were addressed to five main stakeholders-funders, regulators, journals, academic institutions, and researchers. This Review provides some initial observations on the possible effects of the Series, which seems to have provoked several important discussions and is on the agendas of several key players. Some examples of individual initiatives show ways to reduce waste and increase value in biomedical research. This momentum will probably move strongly across stakeholder groups, if collaborative relationships evolve between key players; further important work is needed to increase research value. A forthcoming meeting in Edinburgh, UK, will provide an initial forum within which to foster the collaboration needed.
              Article 0 comments Cited 159 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Trevor A. McGrath: tmcgr043@uottawa.ca
                Mostafa Alabousi: malab101@uottawa.ca
                Becky Skidmore: bskidmore@rogers.com
                Daniël A. Korevaar: d.a.korevaar@amc.uva.nl
                Patrick M. M. Bossuyt: p.m.bossuyt@amc.uva.nl
                David Moher: dmoher@ohri.ca
                Brett Thombs: brett.thombs@mcgill.ca
                Matthew D. F. McInnes: (613)761-4054 , mmcinnes@toh.on.ca
                Journal
                Journal ID (nlm-ta): Syst Rev
                Journal ID (iso-abbrev): Syst Rev
                Title: Systematic Reviews
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2046-4053
                Publication date (Electronic): 10 October 2017
                Publication date PMC-release: 10 October 2017
                Publication date Collection: 2017
                Volume: 6
                Electronic Location Identifier: 194
                Affiliations
                [1 ]ISNI 0000 0001 2182 2255, GRID grid.28046.38, Faculty of Medicine, , University of Ottawa, ; Ottawa, ON Canada
                [2 ]ISNI 0000 0004 1936 8227, GRID grid.25073.33, Department of Radiology, , McMaster University, ; Hamilton, ON Canada
                [3 ]ISNI 0000 0000 9606 5108, GRID grid.412687.e, Ottawa Hospital Research Institute, ; Ottawa, ON Canada
                [4 ]ISNI 0000000084992262, GRID grid.7177.6, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, , University of Amsterdam, ; Amsterdam, the Netherlands
                [5 ]ISNI 0000 0000 9606 5108, GRID grid.412687.e, Clinical Epidemiology Program, Ottawa Hospital Research Institute, ; Ottawa, ON Canada
                [6 ]ISNI 0000 0004 1936 8649, GRID grid.14709.3b, Lady Davis Institute of the Jewish General Hospital and Department of Psychiatry, , McGill University, ; Montreal, Quebec Canada
                [7 ]ISNI 0000 0000 9606 5108, GRID grid.412687.e, University of Ottawa Department of Radiology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, ; Room c159 Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa, ON K1Y 4E9 Canada
                Article
                Publisher ID: 590
                DOI: 10.1186/s13643-017-0590-8
                PMC ID: 5633882
                PubMed ID: 29017574
                SO-VID: e246dd96-f6af-4222-8c00-49f0132a8b99
                Copyright © © The Author(s). 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 4 July 2017
                Date accepted : 28 September 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Award ID: 375751
                Funded by: Canadian Agency for Drugs and Technology in Health
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2017

                ScienceOpen disciplines: Public health
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                ScienceOpen disciplines: Public health

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