Nonparametric meta-analysis for diagnostic accuracy studies

TY - JOUR

T1 - Nonparametric meta-analysis for diagnostic accuracy studies

AU - Zapf, Antonia

AU - Hoyer, Annika

AU - Kramer, Katharina

AU - Kuss, Oliver

N1 - Copyright © 2015 John Wiley & Sons, Ltd.

PY - 2015/12/20

Y1 - 2015/12/20

N2 - Summarizing the information of many studies using a meta-analysis becomes more and more important, also in the field of diagnostic studies. The special challenge in meta-analysis of diagnostic accuracy studies is that in general sensitivity and specificity are co-primary endpoints. Across the studies both endpoints are correlated, and this correlation has to be considered in the analysis. The standard approach for such a meta-analysis is the bivariate logistic random effects model. An alternative approach is to use marginal beta-binomial distributions for the true positives and the true negatives, linked by copula distributions. In this article, we propose a new, nonparametric approach of analysis, which has greater flexibility with respect to the correlation structure, and always converges. In a simulation study, it becomes apparent that the empirical coverage of all three approaches is in general below the nominal level. Regarding bias, empirical coverage, and mean squared error the nonparametric model is often superior to the standard model, and comparable with the copula model. The three approaches are also applied to two example meta-analyses.

AB - Summarizing the information of many studies using a meta-analysis becomes more and more important, also in the field of diagnostic studies. The special challenge in meta-analysis of diagnostic accuracy studies is that in general sensitivity and specificity are co-primary endpoints. Across the studies both endpoints are correlated, and this correlation has to be considered in the analysis. The standard approach for such a meta-analysis is the bivariate logistic random effects model. An alternative approach is to use marginal beta-binomial distributions for the true positives and the true negatives, linked by copula distributions. In this article, we propose a new, nonparametric approach of analysis, which has greater flexibility with respect to the correlation structure, and always converges. In a simulation study, it becomes apparent that the empirical coverage of all three approaches is in general below the nominal level. Regarding bias, empirical coverage, and mean squared error the nonparametric model is often superior to the standard model, and comparable with the copula model. The three approaches are also applied to two example meta-analyses.

KW - Aorta

KW - Computer Simulation

KW - Coronary Artery Disease

KW - Diagnostic Techniques and Procedures

KW - Echocardiography, Transesophageal

KW - Humans

KW - Meta-Analysis as Topic

KW - Models, Statistical

KW - Sensitivity and Specificity

KW - Statistics, Nonparametric

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1002/sim.6583

DO - 10.1002/sim.6583

M3 - SCORING: Journal article

C2 - 26174020

VL - 34

SP - 3831

EP - 3841

JO - STAT MED

JF - STAT MED

SN - 0277-6715

IS - 29

ER -