A methodological review of how heterogeneity has been examined in systematic reviews of diagnostic test accuracy.

Ref ID 733
First Author J. Dinnes
Journal HEALTH TECHNOLOGY ASSESSMENT
Year Of Publishing 2005
URL https://europepmc.org/article/nbk/nbk62298
Keywords Statistical
Diagnostic
Heterogeneity
Problem(s) Lack of statistical expertise in handling of quantitative data
Inadequate analysis of heterogeneity
Number of systematic reviews included 189
Summary of Findings Three-quarters of the included 189 meta-analyses attempted to investigate statistically possible sources of variation, using subgroup analysis or regression analysis. Statistical tests to identify heterogeneity were used in 32% of reviews: 41% of meta-analyses and 9% of reviews using narrative syntheses. The X2 test and Fisher’s exact test to assess heterogeneity in individual aspects of test performance were most commonly used. In contrast, only 16% of meta-analyses used correlation coefficients to test for a threshold effect. The authors highlight that the emphasis on pooling individual aspects of diagnostic test performance and the under-use of statistical tests and graphical approaches to identify heterogeneity perhaps reflect the uncertainty in the most appropriate methods to use and also greater familiarity with more traditional indices of test accuracy. This is an indication of the level of difficulty and complexity of carrying out these reviews. It is strongly suggested that in such reviews meta-analyses are carried out with the involvement of a statistician familiar with the field.
Did the article find that the problem(s) led to qualitative changes in interpretation of the results? Not Applicable
Are the methods of the article described in enough detail to replicate the study? No