Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data

Hierarchical models such as the bivariate and hierarchical summary receiver operating characteristic (HSROC) models are recommended for meta-analysis of test accuracy studies. These models are challenging to fit when there are few studies and/or sparse data (for example zero cells in contingency tab...

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Main Authors: Takwoingi, Yemisi, Guo, Boliang, Riley, Richard D., Deeks, Jonthan J.
Format: Article
Published: Sage 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/31489/
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author Takwoingi, Yemisi
Guo, Boliang
Riley, Richard D.
Deeks, Jonthan J.
author_facet Takwoingi, Yemisi
Guo, Boliang
Riley, Richard D.
Deeks, Jonthan J.
author_sort Takwoingi, Yemisi
building Nottingham Research Data Repository
collection Online Access
description Hierarchical models such as the bivariate and hierarchical summary receiver operating characteristic (HSROC) models are recommended for meta-analysis of test accuracy studies. These models are challenging to fit when there are few studies and/or sparse data (for example zero cells in contingency tables due to studies reporting 100% sensitivity or specificity); the models may not converge, or give unreliable parameter estimates. Using simulation, we investigated the performance of seven hierarchical models incorporating increasing simplifications in scenarios designed to replicate realistic situations for meta-analysis of test accuracy studies. Performance of the models was assessed in terms of estimability (percentage of meta-analyses that successfully converged and percentage where the between study correlation was estimable), bias, mean square error and coverage of the 95% confidence intervals. Our results indicate that simpler hierarchical models are valid in situations with few studies or sparse data. For synthesis of sensitivity and specificity, univariate random effects logistic regression models are appropriate when a bivariate model cannot be fitted. Alternatively, an HSROC model that assumes a symmetric SROC curve (by excluding the shape parameter) can be used if the HSROC model is the chosen meta-analytic approach. In the absence of heterogeneity, fixed effect equivalent of the models can be applied.
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spelling nottingham-314892020-05-04T17:09:58Z https://eprints.nottingham.ac.uk/31489/ Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data Takwoingi, Yemisi Guo, Boliang Riley, Richard D. Deeks, Jonthan J. Hierarchical models such as the bivariate and hierarchical summary receiver operating characteristic (HSROC) models are recommended for meta-analysis of test accuracy studies. These models are challenging to fit when there are few studies and/or sparse data (for example zero cells in contingency tables due to studies reporting 100% sensitivity or specificity); the models may not converge, or give unreliable parameter estimates. Using simulation, we investigated the performance of seven hierarchical models incorporating increasing simplifications in scenarios designed to replicate realistic situations for meta-analysis of test accuracy studies. Performance of the models was assessed in terms of estimability (percentage of meta-analyses that successfully converged and percentage where the between study correlation was estimable), bias, mean square error and coverage of the 95% confidence intervals. Our results indicate that simpler hierarchical models are valid in situations with few studies or sparse data. For synthesis of sensitivity and specificity, univariate random effects logistic regression models are appropriate when a bivariate model cannot be fitted. Alternatively, an HSROC model that assumes a symmetric SROC curve (by excluding the shape parameter) can be used if the HSROC model is the chosen meta-analytic approach. In the absence of heterogeneity, fixed effect equivalent of the models can be applied. Sage 2015-06-26 Article PeerReviewed Takwoingi, Yemisi, Guo, Boliang, Riley, Richard D. and Deeks, Jonthan J. (2015) Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data. Statistical Methods in Medical Research . ISSN 1477-0334 diagnostic accuracy meta-analysis hierarchical models HSROC model bivariate model sensitivity specificity diagnostic odd ration sparse data random effects http://smm.sagepub.com/content/early/2015/06/25/0962280215592269 doi:10.1177/0962280215592269 doi:10.1177/0962280215592269
spellingShingle diagnostic accuracy
meta-analysis
hierarchical models
HSROC model
bivariate model
sensitivity
specificity
diagnostic odd ration
sparse data
random effects
Takwoingi, Yemisi
Guo, Boliang
Riley, Richard D.
Deeks, Jonthan J.
Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data
title Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data
title_full Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data
title_fullStr Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data
title_full_unstemmed Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data
title_short Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data
title_sort performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data
topic diagnostic accuracy
meta-analysis
hierarchical models
HSROC model
bivariate model
sensitivity
specificity
diagnostic odd ration
sparse data
random effects
url https://eprints.nottingham.ac.uk/31489/
https://eprints.nottingham.ac.uk/31489/
https://eprints.nottingham.ac.uk/31489/