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Meta-analysis of diagnostic test accuracy studies with multiple thresholds for data integration
Sung Ryul Shim
Epidemiol Health. 2022;44:e2022083.   Published online September 28, 2022
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  • 169 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
The objective of this study is to introduce methods to use all of the information without omission when individual studies provide multiple effect sizes according to multiple cut-off values (thresholds) during diagnostic test accuracy (DTA) for data integration. For diagnostic test meta-analysis, a general performance method for synthesizing data according to one cut value in one study and a performance method for synthesizing data according to two or more cut values in one study were compared and analyzed.
As sample data for meta-analysis of DTA studies, 13 DTA studies on prostate cancer (34 effect sizes including total cut-offs) were collected. The summary statistics were calculated and the summary line was analyzed using the “meta”, “mada”, and “diagmeta” packagesof the R software.
The summary statistics of the random effect model univariate analysis of the “meta” package with a single cut-off corresponding to the highest Youden index in a single study and those of the bivariate analysis of the “mada” package were highly similar. However, in the bivariate analysis of the “diagmeta” package including all cut-off values, the sensitivity decreased and the specificity increased as the amount of data increased.
Considering the heterogeneity of the summary receiver op erating characteristic curve and the use of all given cut-offs, the use of the bivariate analysis model of the “diagmeta” package is recommended. This study focused on practical methods of DTA rather than theoretical concepts for use by researchers whose fields of study are non-statistics related. By performing this study, we hope that many researchers will use R software to determine the DTA more easily, and that there will be greater interest in related research.
Korean summary
본 연구는 진단검사 메타분석시 개별 대상연구가 다수의 기준치 (cut-off value, threshold)에 따른 여러 개의 효과크기를 제공하고 있을 때, 정보의 누락없이 이를 모두 사용하는 방법과 더불어 기존의 수행방법도 비교 분석하였기에 연구에 적합한 모델 선택에 도움이 될 것이다.
Key Message
The objective of this study is to introduce methods to use all of the information without omission when indi¬vidual studies provide multiple effect sizes according to multiple cut-off values (thresholds) during diagnostic test accuracy (DTA) for data integration.
Shared decision making: relevant concepts and facilitating strategies
Jong-Myon Bae
Epidemiol Health. 2017;39:e2017048.   Published online October 30, 2017
  • 13,789 View
  • 391 Download
  • 44 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
As the paradigm in healthcare nowadays is the evidence-based, patient-centered decision making, the issue of shared decision making (SDM) is highlighted. The aims of this manuscript were to look at the relevant concepts and suggest the facilitating strategies for overcoming barriers of conducting SDM. While the definitions of SDM were discordant, several concepts such as good communication, individual autonomy, patient participants, and patient-centered decision-making were involved. Further, the facilitating strategies of SDM were to educate and train physician, to apply clinical practice guidelines and patient decision aids, to develop valid measurement tools for evaluation of SDM processes, and to investigate the impact of SDM.
Korean summary
오늘날 보건의료가 지향하는 목표가 근거에 기반한 환자중심의 의사결정 (Evidence-based Patient-centered Decision Making)인 점에서, 공유된 의사결정 (Shared Decision Making, SDM)의 중요성이 강조되고 있다. 본 원고는 SDM의 관련 개념들을 정리하고, 진료에 적용하는 과정에서의 한계점들과 이를 극복하기 위한 방안들을 살펴보았다.
Key Message


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