Systematic reviews of diagnostic test accuracy

Mariska M.G. Leeflang, Jonathan J. Deeks, Constantine Gatsonis, Patrick M.M. Bossuyt, Cochrane Diagnostic Test Accuracy Working Group

Research output: Contribution to journalArticlepeer-review

859 Citations (Scopus)


More and more systematic reviews of diagnostic test accuracy studies are being published, but they can be methodologically challenging. In this paper, the authors present some of the recent developments in the methodology for conducting systematic reviews of diagnostic test accuracy studies. Restrictive electronic search filters are discouraged, as is the use of summary quality scores. Methods for meta-analysis should take into account the paired nature of the estimates and their dependence on threshold. Authors of these reviews are advised to use the hierarchical summary receiver-operating characteristic or the bivariate model for the data analysis. Challenges that remain are the poor reporting of original diagnostic test accuracy studies and difficulties with the interpretation of the results of diagnostic test accuracy research.

Original languageEnglish
Pages (from-to)889-897
Number of pages9
JournalAnnals of Internal Medicine
Issue number12
Publication statusPublished - 16 Dec 2008
Externally publishedYes


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