Table 1. Comparison of Meta-Analysis of Therapeutic/Interventional Studies and Diagnostic Test Accuracy Studies.
Therapeutic/Interventional Study | Diagnostic Test Accuracy Study | |
---|---|---|
Number of outcome variables | Single outcome | Pair of outcomes, sensitivity and specificity, which generally inversely correlated |
Analysis of heterogeneity between studies | Chi-square test (Cochrane Q statistic): p < 0.1 generally indicates significant heterogeneity Higgins' I2 statistic: rough guide to interpretation is as follows (10); 0% to 25%, might not be important 25% to 50%, may represent low heterogeneity 50% to 75%, may represent moderate heterogeneity 75% to 100%, high heterogeneity |
Cochrane Q or Higgins' I2 statistics alone may not be informative as they do not consider threshold effect Visual evaluation of coupled forest plot or SROC plot to find threshold effect Spearman correlation analysis between sensitivity and false positive rate: r ≥ 0.6 generally indicates considerable threshold effect (12) |
Meta-analytic summary | Summary point and its 95% CI obtained with Fixed-effects model: when study heterogeneity does not exist Random-effects model: when existence of study heterogeneity is suspected |
Summary point Summary sensitivity and specificity and their 95% CIs obtained with bivariate model: recommended Summary plot (SROC curve) Moses-Littenberg model: not recommended HSROC curve: recommended |
CI = confidence interval, HSROC = hierarchical summary receiver operating characteristic, SROC = summary receiver operating characteristic