Risk of bias assessment of test comparisons was uncommon in comparative accuracy systematic reviews: an overview of reviews

Comparative diagnostic test accuracy systematic reviews (DTA reviews) assess the accuracy of two or more tests and compare their diagnostic performance. We investigated how comparative DTA reviews assessed the risk of bias (RoB) in primary studies that compared multiple index tests. This is an overv...

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Bibliographic Details
Published in:Journal of clinical epidemiology 2020-11, Vol.127, p.167-174
Main Authors: Yang, Bada, Vali, Yasaman, Dehmoobad Sharifabadi, Anahita, Harris, Isobel Marion, Beese, Sophie, Davenport, Clare, Hyde, Christopher, Takwoingi, Yemisi, Whiting, Penny, Langendam, Miranda W., Leeflang, Mariska M.G.
Format: Article
Language:English
Subjects:
Accuracy
Bias
Confidence Intervals
Data Accuracy
Diagnostic accuracy
Diagnostic systems
Diagnostic tests
Diagnostic Tests, Routine - standards
Epidemiology
Humans
Medical diagnosis
Meta-analysis
Patients
Reviews
Risk assessment
Systematic review
Systematic Reviews as Topic
Test comparison
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Summary:Comparative diagnostic test accuracy systematic reviews (DTA reviews) assess the accuracy of two or more tests and compare their diagnostic performance. We investigated how comparative DTA reviews assessed the risk of bias (RoB) in primary studies that compared multiple index tests. This is an overview of comparative DTA reviews indexed in MEDLINE from January 1st to December 31st, 2017. Two assessors independently identified DTA reviews including at least two index tests and containing at least one statement in which the accuracy of the index tests was compared. Two assessors independently extracted data on the methods used to assess RoB in studies that directly compared the accuracy of multiple index tests. We included 238 comparative DTA reviews. Only two reviews (0.8%, 95% confidence interval 0.1 to 3.0%) conducted RoB assessment of test comparisons undertaken in primary studies; neither used an RoB tool specifically designed to assess bias in test comparisons. Assessment of RoB in test comparisons undertaken in primary studies was uncommon in comparative DTA reviews, possibly due to lack of existing guidance on and awareness of potential sources of bias. Based on our findings, guidance on how to assess and incorporate RoB in comparative DTA reviews is needed.
ISSN:0895-4356
1878-5921
DOI:10.1016/j.jclinepi.2020.08.007