Meta-analysis of diagnostic tests with imperfect reference standards
Meta-analysis of diagnostic tests with imperfect reference standards
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DOI：
10.1016/s0895-4356(99)00086-4
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发表时间：
1999-10-01
影响因子：
7.2
通讯作者：
Glasziou, PP
中科院分区：
文献类型：
--
作者：
Walter, SD;Irwig, L;Glasziou, PP
我们提出了一种方法来估计汇总受试者工作特征（SROC）曲线结合信息的诊断测试从几个不同的研究。与以前的方法，假设参考标准是无误差的，我们的方法允许在参考标准中的错误的可能性，通过使用一个潜在的类模型。该模型提供了每个研究中诊断测试的灵敏度和特异性以及病例患病率的估计值;然后可以将这些参数用于荟萃分析，例如，使用Moses等人提出的回归方法，测试区分度的测量值对诊断阈值的测量值的影响，以拟合SROC。以巴氏涂片为例说明了该方法，该示例显示了参考标准品中的不完美性调整通常如何减少SROC图中数据的分散，并倾向于指示比其他方法更好的测试性能。(C)1999 Elsevier Science Inc.
We present a method to estimate the summary receiver operating characteristic (SROC) curve for combining information on a diagnostic test from several different studies. Unlike previous methods that assume the reference standard to be error free, our approach allows for the possibility of errors in the reference standard, through use of a latent class model. The model provides estimates of the sensitivity and specificity of the diagnostic test and the case prevalence in each study; these parameters can then be used in a meta-analysis, for example, using the regression method proposed by Moses et al., of a measure of test discrimination on a measure of the diagnostic threshold, to fit the SROC. The method is illustrated with an example on Pap smears that shows how adjusting for imperfection in the reference standard typically reduces the scatter of data in the SROC plot, and tends to indicate better performance of the test than otherwise. (C) 1999 Elsevier Science Inc.