Systematic reviews of diagnostic tests in cancer: review of methods and reporting.
OBJECTIVE
To assess the methods and reporting of systematic reviews of diagnostic tests.


METHODS
Systematic searches of Medline, Embase, and five other databases identified reviews of tests used in patients with cancer. Of these, 89 satisfied our inclusion criteria of reporting accuracy of the test compared with a reference test, including an electronic search, and published since 1990.


METHODS
All reviews were assessed for methods and reporting of objectives, search strategy, participants, clinical setting, index and reference tests, study design, study results, graphs, meta-analysis, quality, bias, and procedures in the review. We assessed 25 randomly selected reviews in more detail.


RESULTS
75% (67) of the reviews stated inclusion criteria, 49% (44) tabulated characteristics of included studies, 40% (36) reported details of study design, 17% (15) reported on the clinical setting, 17% (15) reported on the severity of disease in participants, and 49% (44) reported on whether the tumours were primary, metastatic, or recurrent. Of the 25 reviews assessed in detail, 68% (17) stated the reference standard used in the review, 36% (9) reported the definition of a positive result for the index test, and 56% (14) reported sensitivity, specificity, and sample sizes for individual studies. Of the 89 reviews, 61% (54) attempted to formally synthesise results of the studies and 32% (29) reported formal assessments of study quality.


CONCLUSIONS
Reliability and relevance of current systematic reviews of diagnostic tests is compromised by poor reporting and review methods.
Mallett
Susan
S
Centre for Statistics in Medicine, University of Oxford, Wolfson College, Oxford OX2 6UD. susan.mallett@cancer.org.uk
Deeks
Jonathan J
JJ
Halligan
Steve
S
Hopewell
Sally
S
Cornelius
Victoria
V
Altman
Douglas G
DG
D015982:Bias; D019937:Diagnostic Techniques and Procedures / Q000592:standards*; D006801:Humans; D015201:Meta-Analysis as Topic; D009369:Neoplasms / Q000175:diagnosis*; D015203:Reproducibility of Results; D000078202:Systematic Reviews as Topic