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Systematic reviews of diagnostic test accuracy studies. 4: Advanced meta-analysis of diagnostic test performance: investigating heterogeneity and comparing tests.

Petra Macaskill and Constantine Gatsonis.
Cochrane Screening and Diagnostic Tests Methods Group.

petram doesnotexist@cochrane.org health.usyd.edu.au


Objective: The workshop will provide an introduction to regression methods for summary ROC analysis, using both fixed-effect and random-effects (hierarchical) models.
At the end of the workshop, participants will be aware of the alternative models, their application and interpretation.
Summary: The workshop will focus on the meta-analysis of studies reporting estimates of test sensitivity and specificity, and summary ROC methods that account for differences in positivity threshold between studies. The use of these models for investigating sources of heterogeneity through the inclusion of study level covariates, as an alternative to subgroup analysis, will be described and discussed. The application of this approach to comparing the performance of tests will also be discussed. The potential advantages of using hierarchical models will be outlined. Examples, drawn from imaging and laboratory test evaluations, will be used to illustrate and compare alternative (fixed-effect and random-effects) models and their interpretation. Sample programs will be provided for fitting hierarchical models in SAS.

The workshop will provide opportunities for discussion about the pros and cons of alternative methods, and interpretation of results.


Level of knowledge required to attend: intermediate.