Diagnostic test accuracy (DTA) systematic reviews are conducted to summarise evidence on the accuracy of a diagnostic test including a critical evaluation of the primary studies. Where appropriate, the evidence is meta‐analysed to obtain pooled estimates of effectiveness.
In this study, we reviewed and critiqued three DTA guidance documents with respect to the graphical presentation of DTA meta‐analysis results. All three documents recommended the use of two forms of graphical presentation: i) forest plots displaying meta‐analysis results for sensitivity (i.e. the true positive rate) and specificity (i.e. true negative rate) separately, and ii) Summary Receiver Operating Characteristic (SROC) curve to provide a global summary of test performance. Two primary shortcomings were identified: i) lack of incorporation of quality assessment results into the main analysis and; ii) ambiguity with which the contribution of individual studies is represented on SROC curves. In response, two alternative graphical approaches were developed:
i) A quality assessment enhanced SROC plot which displays the results from individual studies in the meta‐analysis with multiple indicators of quality assessed using QUADAS‐2; and.
ii) A percentage study weights enhanced SROC plot which accurately portrays the percentage contribution each study makes to the meta‐analysis.
This article is protected by copyright. All rights reserved.