Levente Kriston, PhD; Martin Härter, MD, PhD; Lars Hölzel, MA
Potential Financial Conflicts of Interest: None disclosed.
Kriston L, Härter M, Hölzel L. Challenges in Reporting Meta-analyses of Diagnostic Accuracy Studies. Ann Intern Med. 2009;150:430. doi: 10.7326/0003-4819-150-6-200903170-00025
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Published: Ann Intern Med. 2009;150(6):430.
TO THE EDITOR:
In a recent meta-analysis (1), we compared the diagnostic accuracy of 2 tests for detecting unhealthy alcohol use. We applied the currently recommended hierarchical summary receiver-operating characteristic curve (ROC) analysis to synthesize findings of primary research (2). However, we were uncertain how to present our findings.
First, for a comprehensive research report, the choice of what should be reported is essential. Our analysis provided numerous results, from which we had to select a manageable amount. Point estimates, such as pooled sensitivity and specificity, may be preferred by clinicians. Furthermore, under certain assumptions, they can easily be converted into predictive values, which are even more familiar to many practitioners. But because the included studies applied different thresholds for defining test positivity, these estimates are affected by the primary authors' subjective tradeoff between sensitivity and specificity, which showed substantial heterogeneity. Therefore, we focused our interpretation mainly on the characteristics of summary ROC curves.
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