Reporting quality of diagnostic accuracy studies: a systematic review and meta-analysis of investigations on adherence to STARD

Korevaar, Daniël A.; Enst, Wynanda A. van; Spijker, René; Bossuyt, Patrick M.; Hooft, Lotty

doi:10.1136/eb-2013-101637

Cited by 97 publications

(84 citation statements)

References 32 publications

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“…Therefore, the selection was further limited to reviews that included a meta-analysis. Availability of the two-by-two tables of the included studies was not amongst the inclusion criteria to generate a representative cohort of reviews without possible selection on high level of reporting and perhaps review quality [21]. Studies that assessed the accuracy by means of individual patient data were excluded as the methodology of such studies differs from those of meta-analyses on a study level.…”

Section: Methodsmentioning

confidence: 99%

Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

Enst

Ochodo

Scholten

et al. 2014

BMC Med Res Methodol

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BackgroundThe validity of a meta-analysis can be understood better in light of the possible impact of publication bias. The majority of the methods to investigate publication bias in terms of small study-effects are developed for meta-analyses of intervention studies, leaving authors of diagnostic test accuracy (DTA) systematic reviews with limited guidance. The aim of this study was to evaluate if and how publication bias was assessed in meta-analyses of DTA, and to compare the results of various statistical methods used to assess publication bias.MethodsA systematic search was initiated to identify DTA reviews with a meta-analysis published between September 2011 and January 2012. We extracted all information about publication bias from the reviews and the two-by-two tables. Existing statistical methods for the detection of publication bias were applied on data from the included studies.ResultsOut of 1,335 references, 114 reviews could be included. Publication bias was explicitly mentioned in 75 reviews (65.8%) and 47 of these had performed statistical methods to investigate publication bias in terms of small study-effects: 6 by drawing funnel plots, 16 by statistical testing and 25 by applying both methods. The applied tests were Egger’s test (n = 18), Deeks’ test (n = 12), Begg’s test (n = 5), both the Egger and Begg tests (n = 4), and other tests (n = 2). Our own comparison of the results of Begg’s, Egger’s and Deeks’ test for 92 meta-analyses indicated that up to 34% of the results did not correspond with one another.ConclusionsThe majority of DTA review authors mention or investigate publication bias. They mainly use suboptimal methods like the Begg and Egger tests that are not developed for DTA meta-analyses. Our comparison of the Begg, Egger and Deeks tests indicated that these tests do give different results and thus are not interchangeable. Deeks’ test is recommended for DTA meta-analyses and should be preferred.

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Section: Methodsmentioning

confidence: 99%

Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

Enst

Ochodo

Scholten

et al. 2014

BMC Med Res Methodol

Self Cite

318

196

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“…Since the publication of STARD, several evaluations have pointed to small but statistically significant improvements in reporting accuracy studies (mean gain 1.4 items; 95% CI 0.7 to 2.2) (5,10 ). Gradually, more of the essential items are being reported, but the situation remains far from optimal.…”

Section: The 2003 Stard Statementmentioning

confidence: 99%

STARD 2015: An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies

et al. 2015

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Incomplete reporting has been identified as a major source of avoidable waste in biomedical research. Essential information is often not provided in study reports, impeding the identification, critical appraisal, and replication of studies. To improve the quality of reporting of diagnostic accuracy studies, the Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement was developed. Here we present STARD 2015, an updated list of 30 essential items that should be included in every report of a diagnostic accuracy study. This update incorporates recent evidence about sources of bias and variability in diagnostic accuracy and is intended to facilitate the use of STARD. As such, STARD 2015 may help to improve completeness and transparency in reporting of diagnostic accuracy studies. © 2015 American Association for Clinical ChemistryAs researchers, we talk and write about our studies, not just because we are happy-or disappointed-with the findings, but also to allow others to appreciate the validity of our methods, to enable our colleagues to replicate what we did, and to disclose our findings to clinicians, other health care professionals, and decision-makers, all of whom rely on the results of strong research to guide their actions.Unfortunately, deficiencies in the reporting of research have been highlighted in several areas of clinical medicine (1 ). Essential elements of study methods are often poorly described and sometimes completely omitted, making both critical appraisal and replication difficult, if not impossible. Sometimes study results are selectively reported, and other times researchers cannot resist unwarranted optimism in interpretation of their findings (2-4 ). These practices limit the value of the research and any downstream products or activities, such as systematic reviews and clinical practice guidelines.Reports of studies of medical tests are no exception. A growing number of evaluations have identified deficiencies in the reporting of test accuracy studies (5 ). These are studies in which a test is evaluated against a clinical reference standard, or gold standard; the results are typically reported as estimates of the test's sensitivity and specificity, which express how good the test is in correctly identifying patients as having the target condition. Other accuracy statistics can be used as well, such as the area under the ROC curve or positive and negative predictive values.Despite their apparent simplicity, such studies are at risk of bias (6, 7 ). If not all patients undergoing testing are included in the final analysis, for example, or if only healthy controls are included, the estimates of test accuracy may not reflect the performance of the test in clinical

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“…[4][5][6] Essential information about included patients, study design and the actual results is frequently missing, and recommendations about the test under evaluation are often generous and too optimistic.…”

Section: Introductionmentioning

confidence: 99%

STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration

et al. 2016

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Diagnostic accuracy studies are, like other clinical studies, at risk of bias due to shortcomings in design and conduct, and the results of a diagnostic accuracy study may not apply to other patient groups and settings. Readers of study reports need to be informed about study design and conduct, in sufficient detail to judge the trustworthiness and applicability of the study findings. The STARD statement (Standards for Reporting of Diagnostic Accuracy Studies) was developed to improve the completeness and transparency of reports of diagnostic accuracy studies. STARD contains a list of essential items that can be used as a checklist, by authors, reviewers and other readers, to ensure that a report of a diagnostic accuracy study contains the necessary information. STARD was recently updated. All updated STARD materials, including the checklist, are available at http://www.equator-network.org/reporting-guidelines/stard. Here, we present the STARD 2015 explanation and elaboration document. Through commented examples of appropriate reporting, we clarify the rationale for each of the 30 items on the STARD 2015 checklist, and describe what is expected from authors in developing sufficiently informative study reports.

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Reporting quality of diagnostic accuracy studies: a systematic review and meta-analysis of investigations on adherence to STARD

Cited by 97 publications

References 32 publications

Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

STARD 2015: An Updated List of Essential Items for Reporting Diagnostic Accuracy Studies

STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration

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