GRADE Guidance: 31. Assessing the certainty across a body of evidence for comparative test accuracy

Yang, Bada; Mustafa, Reem A.; Bossuyt, Patrick M.; Brožek, Jan; Hultcrantz, Monica; Leeflang, Mariska; Langendam, Miranda

doi:10.1016/j.jclinepi.2021.04.001

Cited by 29 publications

(19 citation statements)

References 24 publications

(44 reference statements)

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“…On a meta-analysis being deemed appropriate by the reviewers, a statistical test of heterogeneity will be carried out, providing an I 2 value in the heterogeneity of the sample. 36 The I 2 value will be reported as a percentage and interpreted as suggested in the Cochrane Handbook for Systematic Reviews. 23 Significance in the measure of heterogeneity as calculated by the χ 2 test will be set at p≤0.10.…”

Section: Methods and Analysismentioning

confidence: 99%

“…The pooled data will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to evaluate the overall quality and ‘certainty of recommendations’ from the literature. 36–38 The GRADE approach will be used to determine the certainty and strength of evidence according to the categories (methodological and outcome based/results) in table 2 and carried out in accordance with set recommendations. For example, observational studies will be assigned a ‘low’ certainty of recommendation prior to then either being upgraded or downgraded from this point, based on the quality of the evidence.…”

Section: Methods and Analysismentioning

confidence: 99%

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Accuracy of blood-based biomarkers for screening precancerous colorectal lesions: a protocol for systematic review and meta-analysis

et al. 2022

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IntroductionColorectal cancer (CRC) is the third most diagnosed cancer and the second most common cause of cancer mortality worldwide. Most CRCs develop through either the adenoma-to-carcinoma or the serrated pathways, and, therefore, detection and removal of these precursor lesions can prevent the development of cancer. Current screening programmes can aid in the detection of CRC and adenomas; however, participation rates are suboptimal. Blood-based biomarkers may help to address these low participation rates in screening programmes. Although blood-based biomarker tests show promise for cancer detection, limited attention has been placed on the sensitivity and specificity for detection of the precursor lesions. The aim of this research is to conduct a systematic review and meta-analysis to evaluate the accuracy of blood-based biomarker tests in detecting advanced precancerous lesions.Methods and analysisThis protocol was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocols (PRISMA-P) and results will be reported in line with the PRISMA guidelines. Literature searches will be conducted on PubMed, Embase and Web of Science. Two reviewers will conduct the searches, and independently screen them, according to title and abstract and then the full-text versions of those selected articles as well as the risk of bias via the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2) tool. The Grading of Recommendations Assessment, Development and Evaluation guidelines will be used to validate the certainty of evidence for recommendations based on the risk of bias findings. Meta-analysis will be conducted where appropriate on groups of studies with low heterogeneity.Ethics and disseminationNo patient data will be included in our review and, therefore, ethics approval is not required. It is anticipated that the review will identify the most promising candidate biomarkers for clinical translation in the screening of advanced precancerous lesions. The results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42021285173.

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Section: Methods and Analysismentioning

confidence: 99%

Section: Methods and Analysismentioning

confidence: 99%

Accuracy of blood-based biomarkers for screening precancerous colorectal lesions: a protocol for systematic review and meta-analysis

et al. 2022

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“…Ideally, QUADAS-C results should also be incorporated in the conclusions of systematic reviews ( 22). Risk of bias judgments can further inform assessments of the certainty, quality, or strength of the overall body of evidence (23).…”

Section: Answering Signaling Questionsmentioning

confidence: 99%

QUADAS-C: A Tool for Assessing Risk of Bias in Comparative Diagnostic Accuracy Studies

Yang

Mallett

Takwoingi³

et al. 2021

Ann Intern Med

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110

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Comparative diagnostic test accuracy studies assess and compare the accuracy of two or more tests in the same study. While these studies have the potential to yield reliable evidence regarding comparative accuracy, shortcomings in the design, conduct, and analysis may bias their results. The currently recommended quality assessment tool for diagnostic test accuracy studies, QUADAS-2, is not designed for the assessment of test comparisons.We developed QUADAS-C as an extension to QUADAS-2 to assess the risk of bias in comparative diagnostic test accuracy studies. Through a four-round Delphi study involving 24 international experts in test evaluation and a face-to-face consensus meeting, we developed an initial version of the tool which was revised and finalized following a pilot study among potential users.QUADAS-C retains the same four-domain structure of QUADAS-2 (Patient Selection, Index Test, Reference Standard, and Flow and Timing) and is comprised of additional questions to each QUADAS-2 domain. A risk of bias judgment for comparative accuracy requires a risk of bias judgment for the accuracy of each test (resulting from QUADAS-2) and additional criteria specific to test comparisons. Examples of such additional criteria include whether participants either received all index tests or were randomized to index tests, and whether index tests were interpreted blind to the results of other index tests.QUADAS-C will be useful for systematic reviews of diagnostic test accuracy addressing comparative questions. Furthermore, researchers may use this tool to identify and avoid risk of bias when designing a comparative diagnostic test accuracy study.

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“…The confidence of the final included studies will be assessed using the Grading of Recommendations Assessment, Development and Evaluation rating scale 41…”

Section: Eligibility Criteriamentioning

confidence: 99%

Effects of mobile-based mindfulness meditation for mental health of nurses: a protocol for systematic review and meta-analysis

et al. 2022

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IntroductionExisting studies have shown that mobile-based mindfulness meditation (MMM) can have a certain impact on nurses’ mental health problems, but its specific effect and the effect on specific mental health problems such as stress, anxiety, depression, mindfulness, well-being and resilience are not clear.Methods and analysisThis study protocol follows the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guidelines. Electronic search through PubMed, Web of Science, EBSCO, Cochrane Library, CINAHL, PsycINFO, ERIC, Embase and three Chinese databases namely CNKI, Wan Fang and Chinese Biology Medicine disc. The inclusion criteria follow the PICO principle, which is defined translate the question into a searchable and answerable question . P (patient/population): clinical characteristics of patients; I (intervention or exposure): treatment measures or exposure factors of concern; C (comparison): control measure.; O (outcome): outcome indicator of concern. Registered nurses, preregistered nurses, midwives and nursing students will all be included, studies using MMM as intervention to improve mental health of nurses, compared with waitlist controls or traditional methods groups, outcomes assessment of stress, anxiety, depression, mindfulness, well-being and resilience will meet the inclusion criteria. Studies designed randomised controlled trails (RCTs) of quasiexperimental and written in English or Chinese will be eligible. Search time was from inception of each database to July 2022. Two reviewers screen and assess studies for inclusion and extract data independently; any dispute will be settled through discussion. If the discussion still fails, the third author will make a decision. For RCT, risk of bias will be assessed using Cochrane risk-of-bias tool for randomised trials (RoB 2), and for non-RCT studies, risk of bias in non-randomised studies of interventions (ROBINS-I) tool will be performed. Meta-analysis will be performed using RevMan software if sufficient number of comparable studies are retrieved.Ethics and disseminationThis is a study protocol of meta-analysis; no primary data will be collected, and no ethics assessment is required. The study results will be presented in a peer-reviewed scientific publication.PROSPERO registration numberCRD42021277932.

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GRADE Guidance: 31. Assessing the certainty across a body of evidence for comparative test accuracy

Cited by 29 publications

References 24 publications

Accuracy of blood-based biomarkers for screening precancerous colorectal lesions: a protocol for systematic review and meta-analysis

Accuracy of blood-based biomarkers for screening precancerous colorectal lesions: a protocol for systematic review and meta-analysis

QUADAS-C: A Tool for Assessing Risk of Bias in Comparative Diagnostic Accuracy Studies

Effects of mobile-based mindfulness meditation for mental health of nurses: a protocol for systematic review and meta-analysis

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