Dimou Niki L, Adam Maria, Bagos Pantelis G
Department of Computer Science and Biomedical Informatics, University of Thessaly, Papasiopoulou 2-4, Lamia, 35100, Greece.
Stat Med. 2016 Sep 10;35(20):3509-23. doi: 10.1002/sim.6919. Epub 2016 Mar 4.
We present here an extension of the classic bivariate random effects meta-analysis for the log-transformed sensitivity and specificity that can be applied for two or more diagnostic tests. The advantage of this method is that a closed-form expression is derived for the calculation of the within-studies covariances. The method allows the direct calculation of sensitivity and specificity, as well as, the diagnostic odds ratio, the area under curve and the parameters of the summary receiver operator's characteristic curve, along with the means for a formal comparison of these quantities for different tests. There is no need for individual patient data or the simultaneous evaluation of both diagnostic tests in all studies. The method is simple and fast; it can be extended for several diagnostic tests and can be fitted in nearly all statistical packages. The method was evaluated in simulations and applied in a meta-analysis for the comparison of anti-cyclic citrullinated peptide antibody and rheumatoid factor for discriminating patients with rheumatoid arthritis, with encouraging results. Simulations suggest that the method is robust and more powerful compared with the standard bivariate approach that ignores the correlation between tests. Copyright © 2016 John Wiley & Sons, Ltd.
我们在此展示了经典双变量随机效应荟萃分析的一种扩展方法，用于对数转换后的敏感度和特异度，该方法可应用于两项或更多项诊断试验。此方法的优势在于，可推导出用于计算研究内协方差的封闭形式表达式。该方法允许直接计算敏感度、特异度、诊断比值比、曲线下面积以及汇总接受者操作特征曲线的参数，同时还能计算这些量在不同试验间进行正式比较的均值。无需个体患者数据，也无需在所有研究中同时评估两项诊断试验。该方法简单快速；可扩展用于多项诊断试验，且几乎能在所有统计软件包中使用。该方法在模拟中得到评估，并应用于一项荟萃分析，用于比较抗环瓜氨酸肽抗体和类风湿因子对类风湿关节炎患者的鉴别诊断，结果令人鼓舞。模拟表明，与忽略试验间相关性的标准双变量方法相比，该方法稳健且效能更高。版权所有© 2016约翰·威利父子有限公司。
