Meta-epidemiologic study showed frequent time trends in summary estimates from meta-analyses of diagnostic accuracy studies

Jérémie F Cohen; Daniël A Korevaar; Junfeng Wang; Mariska M Leeflang; Patrick M Bossuyt

doi:10.1016/j.jclinepi.2016.04.013

Meta-epidemiologic study showed frequent time trends in summary estimates from meta-analyses of diagnostic accuracy studies

J Clin Epidemiol. 2016 Sep:77:60-67. doi: 10.1016/j.jclinepi.2016.04.013. Epub 2016 May 20.

Authors

Jérémie F Cohen¹, Daniël A Korevaar², Junfeng Wang², Mariska M Leeflang², Patrick M Bossuyt²

Affiliations

¹ Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands; INSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS), Paris Descartes University, 53, avenue de l'Observatoire, 75014 Paris, France; Department of Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, 149, rue de Sèvres, 75015 Paris, France. Electronic address: j.f.cohen@amc.uva.nl.
² Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands.

PMID: 27212137
DOI: 10.1016/j.jclinepi.2016.04.013

Abstract

Objectives: To evaluate changes over time in summary estimates from meta-analyses of diagnostic accuracy studies.

Study design and setting: We included 48 meta-analyses from 35 MEDLINE-indexed systematic reviews published between September 2011 and January 2012 (743 diagnostic accuracy studies; 344,015 participants). Within each meta-analysis, we ranked studies by publication date. We applied random-effects cumulative meta-analysis to follow how summary estimates of sensitivity and specificity evolved over time. Time trends were assessed by fitting a weighted linear regression model of the summary accuracy estimate against rank of publication.

Results: The median of the 48 slopes was -0.02 (-0.08 to 0.03) for sensitivity and -0.01 (-0.03 to 0.03) for specificity. Twelve of 96 (12.5%) time trends in sensitivity or specificity were statistically significant. We found a significant time trend in at least one accuracy measure for 11 of the 48 (23%) meta-analyses.

Conclusion: Time trends in summary estimates are relatively frequent in meta-analyses of diagnostic accuracy studies. Results from early meta-analyses of diagnostic accuracy studies should be considered with caution.

Keywords: Cumulative meta-analysis; Diagnostic accuracy; Meta-analysis; Sensitivity and specificity; Systematic reviews; Time trends.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Diagnostic Tests, Routine / standards*
Epidemiologic Studies*
Humans
Meta-Analysis as Topic*
Reproducibility of Results
Sensitivity and Specificity
Time