Small-study effects and time trends in diagnostic test accuracy meta-analyses : a meta-epidemiological study

dc.contributor.authorVan Enst, Wynanda Anneflooren_ZA
dc.contributor.authorNaaktgeboren, Christiana A.en_ZA
dc.contributor.authorOchodo, Eleanor A.en_ZA
dc.contributor.authorDe Groot, Joris A. H.
dc.contributor.authorLeeflang, Mariska M.en_ZA
dc.contributor.authorReitsma, Johannes B.en_ZA
dc.contributor.authorScholten, Rob J. P. M.en_ZA
dc.contributor.authorMoons, Karel G. M.en_ZA
dc.contributor.authorZwinderman, Aeilko H.en_ZA
dc.contributor.authorBossuyt, Patrick M. M.en_ZA
dc.contributor.authorHooft, Lottyen_ZA
dc.date.accessioned2015-08-24T13:34:07Z
dc.date.available2015-08-24T13:34:07Z
dc.date.issued2015-05-09
dc.date.updated2015-08-04T16:51:14Z
dc.descriptionCITATION: Van Enst, W. A., et al. 2015. Small-study effects and time trends in diagnostic test accuracy meta-analyses : a meta-epidemiological study. Systematic Reviews, 4:66, doi:10.1186/s13643-015-0049-8.
dc.descriptionThe original publication is available at http://systematicreviewsjournal.biomedcentral.com
dc.description.abstractBackground: Small-study effects and time trends have been identified in meta-analyses of randomized trials. We evaluated whether these effects are also present in meta-analyses of diagnostic test accuracy studies. Methods: A systematic search identified test accuracy meta-analyses published between May and September 2012. In each meta-analysis, the strength of the associations between estimated accuracy of the test (diagnostic odds ratio (DOR), sensitivity, and specificity) and sample size and between accuracy estimates and time since first publication were evaluated using meta-regression models. The regression coefficients over all meta-analyses were summarized using random effects meta-analysis. Results: Forty-six meta-analyses and their corresponding primary studies (N = 859) were included. There was a non-significant relative change in the DOR of 1.01 per 100 additional participants (95% CI 1.00 to 1.03; P = 0.07). In the subgroup of imaging studies, there was a relative increase in sensitivity of 1.13 per 100 additional diseased subjects (95% CI 1.05 to 1.22; P = 0.002). The relative change in DOR with time since first publication was 0.94 per 5 years (95% CI 0.80 to 1.10; P = 0.42). Sensitivity was lower in studies published later (relative change 0.89, 95% CI 0.80 to 0.99; P = 0.04). Conclusions: Small-study effects and time trends do not seem to be as pronounced in meta-analyses of test accuracy studies as they are in meta-analyses of randomized trials. Small-study effects seem to be reversed in imaging, where larger studies tend to report higher sensitivity.en
dc.description.urihttp://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-015-0049-8
dc.description.versionPublisher's version
dc.format.extent7 pages
dc.identifier.citationVan Enst, W. A., et al. 2015. Small-study effects and time trends in diagnostic test accuracy meta-analyses : a meta-epidemiological study. Systematic Reviews, 4:66, doi:10.1186/s13643-015-0049-8
dc.identifier.issn2046-4053 (online)
dc.identifier.issn2046-4053 (print)
dc.identifier.otherdoi:10.1186/s13643-015-0049-8
dc.identifier.urihttp://hdl.handle.net/10019.1/97392
dc.language.rfc3066en
dc.publisherBioMed Central
dc.rights.holderAuthors retain copyright
dc.subjectDiagnostic test accuracyen_ZA
dc.subjectDiagnosis, Noninvasiveen_ZA
dc.subjectSystematic reviews (Medical research)en_ZA
dc.subjectMeta-analysisen_ZA
dc.subjectSmall-study effectsen_ZA
dc.subjectTime trendsen_ZA
dc.titleSmall-study effects and time trends in diagnostic test accuracy meta-analyses : a meta-epidemiological study
dc.typeArticle
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