Guidance for deriving and presenting percentage study weights in meta-analysis of test accuracy studies
Guidance for deriving and presenting percentage study weights in meta-analysis of test accuracy studies
复制标题
DOI：
10.1002/jrsm.1283
复制
发表时间：
2018-06-01
影响因子：
9.8
通讯作者：
Riley, Richard D.
中科院分区：
文献类型：
--
作者：
Burke, Danielle L.;Ensor, Joie;Riley, Richard D.
荟萃分析中的研究权重百分比揭示了每项研究对总体总结结果的贡献，当某些研究被认为是离群值或存在高偏倚风险时尤为重要。在试验准确性审查的荟萃分析中，例如敏感性和特异性的双变量荟萃分析，目前未推导出研究权重百分比。相反，重点是通过相对于研究样本量或其标准误缩放点，在受试者工作特征图上表示研究估计值的精密度。在这篇文章中，我们建议研究人员也应该直接提供百分比的研究权重，我们提出了一种方法来获得他们的基础上分解的Fisher信息矩阵。该方法还推广到二元荟萃回归，因此也可以推导出百分比研究权重，用于估计测试准确性的研究水平修饰符。应用程序是两个荟萃分析检查测试的准确性：一个耳温诊断发烧的儿童和其他的正电子发射断层扫描诊断阿尔茨海默氏病。这些突出显示了百分比研究权重提供了重要信息，如果仅关注基于样本量或标准误差的精度，则这些信息会被隐藏。软件代码提供的Stata，我们建议，我们提出的百分比权重应定期添加到森林和接收器操作特性图的灵敏度和特异性，提供透明度的贡献，每个研究的结果。这对目前正在制定的PRISMA诊断测试准确性指南有影响。
Percentage study weights in meta-analysis reveal the contribution of each study toward the overall summary results and are especially important when some studies are considered outliers or at high risk of bias. In meta-analyses of test accuracy reviews, such as a bivariate meta-analysis of sensitivity and specificity, the percentage study weights are not currently derived. Rather, the focus is on representing the precision of study estimates on receiver operating characteristic plots by scaling the points relative to the study sample size or to their standard error. In this article, we recommend that researchers should also provide the percentage study weights directly, and we propose a method to derive them based on a decomposition of Fisher information matrix. This method also generalises to a bivariate meta-regression so that percentage study weights can also be derived for estimates of study-level modifiers of test accuracy. Application is made to two meta-analyses examining test accuracy: one of ear temperature for diagnosis of fever in children and the other of positron emission tomography for diagnosis of Alzheimer's disease. These highlight that the percentage study weights provide important information that is otherwise hidden if the presentation only focuses on precision based on sample size or standard errors. Software code is provided for Stata, and we suggest that our proposed percentage weights should be routinely added on forest and receiver operating characteristic plots for sensitivity and specificity, to provide transparency of the contribution of each study toward the results. This has implications for the PRISMA-diagnostic test accuracy guidelines that are currently being produced.