title: Verification bias in diagnostic accuracy studies for fine- and core needle biopsy of salivary gland lesions in otolaryngology journals: a systematic review and analysis.
abstract: BACKGROUND
  Diagnostic test accuracy (DTA) studies for needle biopsy are frequently published in otolaryngology journals, but this body of literature has not been assessed for verification bias.
  
  
  METHODS
  We conducted a systematic review of DTA studies on needle biopsy of salivary gland lesions appearing in otolaryngology journals. Studies were assessed by 2 reviewers for verification bias.
  
  
  RESULTS
  We identified 95 DTA studies for needle biopsy of salivary gland lesions. Eighty-one studies (84%) had verification bias. Five of the biased studies provided sufficient data to estimate the extent of bias. Verification bias was associated with an overestimate of sensitivity and an underestimate of specificity. Studies on core needle biopsy (CNB) had a lower rate of verification bias than fine-needle aspiration (FNA) studies.
  
  
  CONCLUSIONS
  Verification bias is common in DTA studies of needle biopsy for salivary gland lesions published in ear, nose, and throat (ENT) journals. Such studies overestimated sensitivity and underestimated specificity.
authors.affiliation: Department of Pathology and ARUP Laboratories, University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Schmidt
authors.forename: Jolanta D
authors.initials: JD
authors.lastname: Jedrzkiewicz
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Allred
authors.forename: Shotaro
authors.initials: S
authors.lastname: Matsuoka
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Witt
mesh_terms: D015982:Bias; D044963:Biopsy, Fine-Needle; D062005:Biopsy, Large-Core Needle; D005260:Female; D006801:Humans; D008297:Male; D010036:Otolaryngology; D010506:Periodicals as Topic; D011786:Quality Control; D012468:Salivary Gland Neoplasms / Q000473:pathology*; D012680:Sensitivity and Specificity
keywords: bias; diagnostic accuracy; fine-needle aspiration; salivary glands; systematic review