Selective Cutoff Reporting in Studies of Diagnostic Test Accuracy: A Comparison of Conventional and Individual-Patient-Data Meta-Analyses of the Patient Health Questionnaire-9 Depression Screening Tool
Standard
Selective Cutoff Reporting in Studies of Diagnostic Test Accuracy: A Comparison of Conventional and Individual-Patient-Data Meta-Analyses of the Patient Health Questionnaire-9 Depression Screening Tool. / Levis, Brooke; Benedetti, Andrea; Levis, Alexander W; Ioannidis, John P A; Shrier, Ian; Cuijpers, Pim; Gilbody, Simon; Kloda, Lorie A; McMillan, Dean; Patten, Scott B; Steele, Russell J; Ziegelstein, Roy C; Bombardier, Charles H; de Lima Osório, Flavia; Fann, Jesse R; Gjerdingen, Dwenda; Lamers, Femke; Lotrakul, Manote; Loureiro, Sonia R; Löwe, Bernd; Shaaban, Juwita; Stafford, Lesley; van Weert, Henk C P M; Whooley, Mary A; Williams, Linda S; Wittkampf, Karin A; Yeung, Albert S; Thombs, Brett D.
in: AM J EPIDEMIOL, Jahrgang 185, Nr. 10, 15.05.2017, S. 954-964.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Selective Cutoff Reporting in Studies of Diagnostic Test Accuracy: A Comparison of Conventional and Individual-Patient-Data Meta-Analyses of the Patient Health Questionnaire-9 Depression Screening Tool
AU - Levis, Brooke
AU - Benedetti, Andrea
AU - Levis, Alexander W
AU - Ioannidis, John P A
AU - Shrier, Ian
AU - Cuijpers, Pim
AU - Gilbody, Simon
AU - Kloda, Lorie A
AU - McMillan, Dean
AU - Patten, Scott B
AU - Steele, Russell J
AU - Ziegelstein, Roy C
AU - Bombardier, Charles H
AU - de Lima Osório, Flavia
AU - Fann, Jesse R
AU - Gjerdingen, Dwenda
AU - Lamers, Femke
AU - Lotrakul, Manote
AU - Loureiro, Sonia R
AU - Löwe, Bernd
AU - Shaaban, Juwita
AU - Stafford, Lesley
AU - van Weert, Henk C P M
AU - Whooley, Mary A
AU - Williams, Linda S
AU - Wittkampf, Karin A
AU - Yeung, Albert S
AU - Thombs, Brett D
N1 - © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2017/5/15
Y1 - 2017/5/15
N2 - In studies of diagnostic test accuracy, authors sometimes report results only for a range of cutoff points around data-driven "optimal" cutoffs. We assessed selective cutoff reporting in studies of the diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) depression screening tool. We compared conventional meta-analysis of published results only with individual-patient-data meta-analysis of results derived from all cutoff points, using data from 13 of 16 studies published during 2004-2009 that were included in a published conventional meta-analysis. For the "standard" PHQ-9 cutoff of 10, accuracy results had been published by 11 of the studies. For all other relevant cutoffs, 3-6 studies published accuracy results. For all cutoffs examined, specificity estimates in conventional and individual-patient-data meta-analyses were within 1% of each other. Sensitivity estimates were similar for the cutoff of 10 but differed by 5%-15% for other cutoffs. In samples where the PHQ-9 was poorly sensitive at the standard cutoff, authors tended to report results for lower cutoffs that yielded optimal results. When the PHQ-9 was highly sensitive, authors more often reported results for higher cutoffs. Consequently, in the conventional meta-analysis, sensitivity increased as cutoff severity increased across part of the cutoff range-an impossibility if all data are analyzed. In sum, selective reporting by primary study authors of only results from cutoffs that perform well in their study can bias accuracy estimates in meta-analyses of published results.
AB - In studies of diagnostic test accuracy, authors sometimes report results only for a range of cutoff points around data-driven "optimal" cutoffs. We assessed selective cutoff reporting in studies of the diagnostic accuracy of the Patient Health Questionnaire-9 (PHQ-9) depression screening tool. We compared conventional meta-analysis of published results only with individual-patient-data meta-analysis of results derived from all cutoff points, using data from 13 of 16 studies published during 2004-2009 that were included in a published conventional meta-analysis. For the "standard" PHQ-9 cutoff of 10, accuracy results had been published by 11 of the studies. For all other relevant cutoffs, 3-6 studies published accuracy results. For all cutoffs examined, specificity estimates in conventional and individual-patient-data meta-analyses were within 1% of each other. Sensitivity estimates were similar for the cutoff of 10 but differed by 5%-15% for other cutoffs. In samples where the PHQ-9 was poorly sensitive at the standard cutoff, authors tended to report results for lower cutoffs that yielded optimal results. When the PHQ-9 was highly sensitive, authors more often reported results for higher cutoffs. Consequently, in the conventional meta-analysis, sensitivity increased as cutoff severity increased across part of the cutoff range-an impossibility if all data are analyzed. In sum, selective reporting by primary study authors of only results from cutoffs that perform well in their study can bias accuracy estimates in meta-analyses of published results.
KW - Bias
KW - Data Accuracy
KW - Depression
KW - Diagnostic Techniques and Procedures
KW - Epidemiologic Methods
KW - Humans
KW - Meta-Analysis as Topic
KW - Sensitivity and Specificity
KW - Journal Article
U2 - 10.1093/aje/kww191
DO - 10.1093/aje/kww191
M3 - SCORING: Journal article
C2 - 28419203
VL - 185
SP - 954
EP - 964
JO - AM J EPIDEMIOL
JF - AM J EPIDEMIOL
SN - 0002-9262
IS - 10
ER -
