Statistical Methods and Software for Meta-Analysis of Diagnostic Tests.

摘要

The primary goal of this R03 project was to develop statistical methods and related software for meta-analysis of diagnostic tests. Comparative effectiveness research relies fundamentally on accurate assessment of clinical outcomes. The growing number of assessment instruments, as well as the rapid escalation in the cost has generated the increasing need for scientifically rigorous comparisons of the diagnostic tests in clinical practice. Meta-analysis of diagnostic tests presents many additional statistical challenges compared to traditional meta-analysis applications such as meta-analysis of controlled clinical trials. In particular, diagnostic accuracy cannot be adequately summarized by one measure; two measures are typically used, most often sensitivity and specificity, or alternatively positive and negative likelihood ratios, and either two are correlated. Furthermore, diagnostic accuracy parameters may depend on disease prevalence.