Title | A trivariate meta-analysis of diagnostic studies accounting for prevalence and non-evaluable subjects: re-evaluation of the meta-analysis of coronary CT angiography studies. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Ma, Xiaoye, Muhammad Fareed K. Suri, and Haitao Chu |
Journal | BMC Med Res Methodol |
Volume | 14 |
Pagination | 128 |
Date Published | 2014 Dec 04 |
ISSN | 1471-2288 |
Keywords | Coronary Angiography, Data Interpretation, Statistical, Diagnostic Techniques, Cardiovascular, Humans, Prevalence, Tomography, X-Ray Computed |
Abstract | BACKGROUND: A recent paper proposed an intent-to-diagnose approach to handle non-evaluable index test results and discussed several alternative approaches, with an application to the meta-analysis of coronary CT angiography diagnostic accuracy studies. However, no simulation studies have been conducted to test the performance of the methods.METHODS: We propose an extended trivariate generalized linear mixed model (TGLMM) to handle non-evaluable index test results. The performance of the intent-to-diagnose approach, the alternative approaches and the extended TGLMM approach is examined by extensive simulation studies. The meta-analysis of coronary CT angiography diagnostic accuracy studies is re-evaluated by the extended TGLMM.RESULTS: Simulation studies showed that the intent-to-diagnose approach under-estimate sensitivity and specificity. Under the missing at random (MAR) assumption, the TGLMM gives nearly unbiased estimates of test accuracy indices and disease prevalence. After applying the TGLMM approach to re-evaluate the coronary CT angiography meta-analysis, overall median sensitivity is 0.98 (0.967, 0.993), specificity is 0.875 (0.827, 0.923) and disease prevalence is 0.478 (0.379, 0.577).CONCLUSIONS: Under MAR assumption, the intent-to-diagnose approach under-estimate both sensitivity and specificity, while the extended TGLMM gives nearly unbiased estimates of sensitivity, specificity and prevalence. We recommend the extended TGLMM to handle non-evaluable index test subjects. |
DOI | 10.1186/1471-2288-14-128 |
Alternate Journal | BMC Med Res Methodol |
Original Publication | A trivariate meta-analysis of diagnostic studies accounting for prevalence and non-evaluable subjects: re-evaluation of the meta-analysis of coronary CT angiography studies. |
PubMed ID | 25475705 |
PubMed Central ID | PMC4280699 |
Grant List | 1R01HL105626 / HL / NHLBI NIH HHS / United States P30 CA077598 / CA / NCI NIH HHS / United States R01 HL105626 / HL / NHLBI NIH HHS / United States U54 MD008620 / MD / NIMHD NIH HHS / United States U54-MD008620 / MD / NIMHD NIH HHS / United States AI103012 / AI / NIAID NIH HHS / United States R21 AI103012 / AI / NIAID NIH HHS / United States P01CA142538 / CA / NCI NIH HHS / United States P01 CA142538 / CA / NCI NIH HHS / United States P30CA077598 / CA / NCI NIH HHS / United States |
A trivariate meta-analysis of diagnostic studies accounting for prevalence and non-evaluable subjects: re-evaluation of the meta-analysis of coronary CT angiography studies.
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