Diagnostic test accuracy network meta-analysis methods: A scoping review and empirical assessment.
J Clin Epidemiol 2022;
146:86-96. [PMID:
35181490 DOI:
10.1016/j.jclinepi.2022.02.001]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/31/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE
To a) identify methodological and application papers reporting a model developed specifically for diagnostic test accuracy network meta-analysis (DTA-NMA) or a hierarchical meta-regression method for comparing at least three index tests; b) review and summarize the characteristics of the methods and the application papers; and c) compare DTA-NMA and hierarchical meta-regression methods empirically.
STUDY DESIGN AND SETTINGS
We performed a scoping review and searched major databases until 3rd March 2021. We assessed the characteristics of the identified methods, conducted a descriptive analysis of characteristics of the application articles, and applied the DTA-NMA and meta-regression methods to the available data.
RESULTS
We included 49 articles, of which 9 were methodological (describing 11 DTA-NMA methods) and 40 were application papers (data available for 32 DTA-NMAs). Our results showed a steep increase in recent years in DTA-NMA publications. DTA-NMA models may lead to different results. Although sensitivity estimates were comparable between meta-regression and DTA-NMA models, specificity estimates were higher in meta-regression.
CONCLUSIONS
The choice of a DTA-NMA model will depend on the available data, including the use of different thresholds for test positivity, different study designs, and software familiarity. Selection between the methods may impact on the NMA results, especially for specificity.
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