Systematic Review and Meta-Analysis of Studies Evaluating Diagnostic Test Accuracy: A Practical Review for Clinical Researchers-Part I. General Guidance and Tips

Kim, Kyung Won; Lee, Jun-Young; Choi, Sang Hyun; Huh, Jimi; Park, Seong Ho

doi:10.3348/kjr.2015.16.6.1175

Cited by 272 publications

(198 citation statements)

References 36 publications

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“…10. However, this statistical criterion may be less appropriate for meta-analysis of diagnostic tests which employ bivariate outcomes (sensitivity and specificity; Kim et al 2015; Lee et al 2015). Tau-squared quantifies the variance across studies, with a value of zero indicating minimal or no heterogeneity in the data.…”

Section: Methodsmentioning

confidence: 99%

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Diagnostic Accuracy of Memory Measures in Alzheimer’s Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

et al. 2017

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With an increasing focus on biomarkers in dementia research, illustrating the role of neuropsychological assessment in detecting mild cognitive impairment (MCI) and Alzheimer’s dementia (AD) is important. This systematic review and meta-analysis, conducted in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) standards, summarizes the sensitivity and specificity of memory measures in individuals with MCI and AD. Both meta-analytic and qualitative examination of AD versus healthy control (HC) studies (n = 47) revealed generally high sensitivity and specificity (≥ 80% for AD comparisons) for measures of immediate (sensitivity = 87%, specificity = 88%) and delayed memory (sensitivity = 89%, specificity = 89%), especially those involving word-list recall. Examination of MCI versus HC studies (n = 38) revealed generally lower diagnostic accuracy for both immediate (sensitivity = 72%, specificity = 81%) and delayed memory (sensitivity = 75%, specificity = 81%). Measures that differentiated AD from other conditions (n = 10 studies) yielded mixed results, with generally high sensitivity in the context of low or variable specificity. Results confirm that memory measures have high diagnostic accuracy for identification of AD, are promising but require further refinement for identification of MCI, and provide support for ongoing investigation of neuropsychological assessment as a cognitive biomarker of preclinical AD. Emphasizing diagnostic test accuracy statistics over null hypothesis testing in future studies will promote the ongoing use of neuropsychological tests as Alzheimer’s disease research and clinical criteria increasingly rely upon cerebrospinal fluid (CSF) and neuroimaging biomarkers.

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Section: Methodsmentioning

confidence: 99%

“…Following methods outlined by Kim et al (2015) and Lee et al (2015), we employed hierarchical methods, known as the bivariate and Rutter & Gatsonis hierarchical summary receiver operating characteristic (HSROC) models, respectively. These are random effect models in that they account for variance within studies as well as across studies.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic Accuracy of Memory Measures in Alzheimer’s Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

et al. 2017

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“…Heterogeneity and inconsistency were assessed using Cochran's Q test and the I 2 statistic, respectively. An alpha value ≤0.10 on the Q test was considered to be representative of statistically significant heterogeneity, while an I 2 statistic greater than 50% was considered to be indicative of substantial inconsistency (Kim, Lee, Choi, Huh, & Park, 2015). Funnel plots were used to visually examine for potential small-study effects (publication bias, etc.).…”

Section: Methodsmentioning

confidence: 99%

The association of hyperglycemia and diabetes mellitus and the risk of chemotherapy-induced neutropenia among cancer patients: A systematic review with meta-analysis

Alenzi

Kelley

2017

Journal of Diabetes and its Complications

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Aim Conduct a systematic review with meta-analysis to determine the association between incident chemotherapy-induced neutropenia (CIN) and either diabetes mellitus (DM) or hyperglycemia in patients with cancer. Methods Observational studies in cancer patients of any age receiving chemotherapy and having diabetes or hyperglycemia either during or before chemotherapy induction were included. Studies were retrieved by searching four databases (PubMed, EBSCO, ProQuest, and Cochrane) and cross-referencing. The metric for combining studies was the odds ratio (OR). Results were pooled using a random-effects model, while heterogeneity and inconsistency were assessed using the Q and I2 statistic, respectively. Potential small-study effects were assessed using the funnel plot. Results Ten studies met the criteria for inclusion. Overall, the odds of having CIN were 32% higher among cancer patients with either DM or hyperglycemia compared with those without DM or hyperglycemia (OR = 1.32, 95% CI, 1.06–1.64). Statistically significant heterogeneity and inconsistency were found (Q = 33.15, p < 0.05, I2 = 72.9%). Funnel plot asymmetry reflecting potential small-study effects was observed. Conclusions Diabetes mellitus and hyperglycemia may be associated with an increased risk for CIN among cancer patients. However, additional well-designed studies are needed before any final and definitive recommendations can be made.

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“…Therefore, it is timely and necessary to collect current data regarding the use of these images for detecting brain metastases. To the best of our knowledge, our present systematic review using DerSimonian-Laird random-effects modeling [17][18][19]. Heterogeneity among studies was determined using the χ 2 statistics for the pooled estimates (p < 0.05, indicating significant heterogeneity) and the inconsistency index, I 2 (0-40 %, might not be important; 30-60 %, may represent moderate heterogeneity; 50-90 %, may represent substantial heterogeneity; 75-100 %, considerable heterogeneity) [20].…”

Section: Inclusion Criteriamentioning

confidence: 99%

The detectability of brain metastases using contrast-enhanced spin-echo or gradient-echo images: a systematic review and meta-analysis

et al. 2016

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This study aimed to compare the detectability of brain metastases using contrast-enhanced spin-echo (SE) and gradient-echo (GRE) T1-weighted images. The Ovid-MEDLINE and EMBASE databases were searched for studies on the detectability of brain metastases using contrast-enhanced SE or GRE images. The pooled proportions for the detectability of brain metastases were assessed using random-effects modeling. Heterogeneity among studies was determined using χ (2) statistics for the pooled estimates and the inconsistency index, I (2) . To overcome heterogeneity, subgroup analyses according to slice thickness and lesion size were performed. A total of eight eligible studies, which included a sample size of 252 patients and 1413 brain metastases, were included. The detectability of brain metastases using SE images (89.2 %) was higher than using GRE images (81.6 %; adjusted 84.0 %), but this difference was not statistically significant (p = 0.2385). In subgroup analysis of studies with 1-mm-thick slices and small metastases (<5 mm in diameter), 3-dimensional (3D) SE images demonstrated a higher detectability in comparison to 3D GRE images (93.7 % vs 73.1 % in 1-mm-thick slices; 89.5 % vs 59.4 % for small metastases) (p < 0.0001). Although both SE or GRE images are acceptable for detecting brain metastases, contrast-enhanced 3D SE images using 1-mm-thick slices are preferred for detecting brain metastases, especially small lesions (<5 mm in diameter).

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Systematic Review and Meta-Analysis of Studies Evaluating Diagnostic Test Accuracy: A Practical Review for Clinical Researchers-Part I. General Guidance and Tips

Cited by 272 publications

References 36 publications

Diagnostic Accuracy of Memory Measures in Alzheimer’s Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

Diagnostic Accuracy of Memory Measures in Alzheimer’s Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

The association of hyperglycemia and diabetes mellitus and the risk of chemotherapy-induced neutropenia among cancer patients: A systematic review with meta-analysis

The detectability of brain metastases using contrast-enhanced spin-echo or gradient-echo images: a systematic review and meta-analysis

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