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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
DOI: https://doi.org/10.4178/epih.e2022083
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
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.
Summary
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.

Citations

Citations to this article as recorded by  
  • Procalcitonin for the diagnosis of postoperative bacterial infection after adult cardiac surgery: a systematic review and meta-analysis
    Davide Nicolotti, Silvia Grossi, Valeria Palermo, Federico Pontone, Giuseppe Maglietta, Francesca Diodati, Matteo Puntoni, Sandra Rossi, Caterina Caminiti
    Critical Care.2024;[Epub]     CrossRef
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