title: Survey of the methods and reporting practices in published meta-analyses of test performance: 1987 to 2009.
abstract: We performed a survey of meta-analyses of test performance to describe the evolution in their methods and reporting. Studies were identified through MEDLINE (1966-2009), reference lists, and relevant reviews. We extracted information on clinical topics, literature review methods, quality assessment, and statistical analyses. We reviewed 760 publications reporting meta-analyses of test performance, published between 1987 and 2009. Eligible reviews included a median of 18 primary studies that were used in quantitative analyses. Most common clinical areas were cardiovascular disease (21%) and oncology (25%); most common test categories were imaging (44%) and biomarker tests (28%). Assessment of verification and spectrum bias, blinding, prospective study design, and consecutive patient recruitment became more common over time (p < 0.001 comparing reviews published through 2004 vs 2005 onwards). These changes coincided with the increasing use of checklists to guide assessment of methodological quality. Heterogeneity tests were used in 58% of meta-analyses; subgroup or regression analyses were used in 57%. Random effects models were employed in 57% of meta-analyses (38% through 2004 vs 72% 2004-onwards; p < 0.001). Use of bivariate models of sensitivity and specificity increased in recent years (21% in 2008-2009 vs 7% in earlier years; p < 0.001). Methods employed in meta-analyses of test performance have improved with the introduction of quality assessment checklists and the development of more sophisticated statistical methods.
authors.affiliation: Center for Evidence-based Medicine, Program in Public Health, Brown University, Providence, RI, USA.
authors.forename: Issa J
authors.initials: IJ
authors.lastname: Dahabreh
authors.affiliation: Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
authors.forename: Mei
authors.initials: M
authors.lastname: Chung
authors.affiliation: Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.|Department of General Internal Medicine, Lahey Clinic Medical Center, Burlington, MA, USA.
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Kitsios
authors.affiliation: Department of Internal Medicine, Fujita Health University Nanakuri Sanatorium, Fujita Health University School of Medicine, Tsu, Mie, Japan.|Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Terasawa
authors.affiliation: Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
authors.forename: Gowri
authors.initials: G
authors.lastname: Raman
authors.affiliation: Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.|Department of Internal Medicine, University of Ioannina School of Medicine, Ioannina, Greece.
authors.forename: Athina
authors.initials: A
authors.lastname: Tatsioni
authors.affiliation: Division of Gastroenterology & Hepatology, Department of Medicine, University of Colorado, Aurora, CO, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: Tobar
authors.affiliation: Center for Evidence-based Medicine, Program in Public Health, Brown University, Providence, RI, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Lau
authors.affiliation: Center for Evidence-based Medicine, Program in Public Health, Brown University, Providence, RI, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Trikalinos
authors.affiliation: Center for Evidence-based Medicine, Program in Public Health, Brown University, Providence, RI, USA.|Department of Biostatistics, Program in Public Health, Brown University, Providence, RI, USA.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Schmid
mesh_terms: D003955:Diagnostic Tests, Routine / Q000145:classification* / Q000706:statistics & numerical data*; D015201:Meta-Analysis as Topic; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010506:Periodicals as Topic / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D058028:Research Report; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
keywords: diagnostic test; meta-analysis; methods; reporting; systematic review; test performance