Software for Meta-Analysis of Diagnostic Tests

描述（由申请人提供）：诊断测试是临床医生用于诊断的测试，即确定某人是否患有特定疾病。例如，在老年学中，已经开发了一系列诊断测试来识别患有阿尔茨海默病的人，并跟踪这种进行性疾病的各个阶段，以确定哪种干预措施最有可能起作用。其他测试用于区分正常的认知变化和痴呆，或诊断急性中风、年龄相关性黄斑变性、年龄相关性认知障碍、骨质疏松症、老年吸入性肺炎、冠状动脉疾病和老年住院患者的谵妄。由于诊断测试很少100%准确，因此我们知道对测试结果有多大信心是至关重要的。用于确定诊断测试的准确性的过程类似于用于确定药物效用的过程。当一种测试最初被开发出来时，它会在一系列研究中进行评估，研究人员会发表论文，详细介绍该测试在这些研究中的表现。随着证据的积累，

DESCRIPTION (provided by applicant): Diagnostic tests are the tests that clinicians use to make a diagnosis, i.e., to determine whether or not a person has a particular disease. In gerontology, for example, an array of diagnostic tests have been developed to identify persons with Alzheimer's Disease, and to track the stages of this progressive disease to determine what kinds of intervention are most likely to be helpful. Other tests are used to distinguish between normal cognitive changes and dementia, or to diagnose acute stroke, age-related macular degeneration, age-related cognitive impairment, osteoporosis, aspiration pneumonia in the elderly, coronary artery disease, and delirium among aged hospital patients. Since diagnostic tests are rarely 100% accurate, it is critically important that we know how much faith we can have in the results of a test. The process used to determine the accuracy of a diagnostic test is similar to the process used to determine the utility of a drug. When a test is initially developed it is evaluated in a series of studies, and researchers will publish papers detailing the performance of the test in these studies. As a body of evidence accumulates, experts will identify the relevant studies and perform a meta-analysis of the data. If the test performance is consistent across the studies, this analysis would provide a more precise estimate of the common accuracy than any of the studies alone. More often, the test performance will vary from one study to the next, and the goal of the meta-analysis would be to determine what factors are responsible for this variation. This could lead to a finding that the test is accurate in some settings but not others, or with some patient groups but not others. The goal of this project is to develop software for meta-analysis of diagnostic tests. The program, which will include modules for data-entry, analysis, and graphics, will be developed in collaboration with some of the leading experts in this field.