METAANALYTIC METHODS FOR DIAGNOSTIC-TEST ACCURACY

Meta-analyses of diagnostic test accuracy are uncommon and often based on separate pooling Of sensitivity and specificity, which can lead to biased estimates. Recently, several appropriate methods have been dev eloped for meta-analysing diagnostic test data from primary studies. P rimary studies usually only provide binary test data, for which Moses et al. have developed a method to estimate Summary Receiver Operating Characteristic Curves, thereby taking account of possible test thresho ld differences between studies. Several methods are also available for analysing multicategory and continuous test,data. The usefulness of a pplying these methods is constrained by publication bias and the gener ally poor quality of primary studies of diagnostic test accuracy. Meta -analysts need to highlight important defects in quality and how they affect summary estimates to ensure that better primary studies are ava ilable for meta-analysis in the future.