Systematic reviews of diagnostic test accuracy

Ann Intern Med. 2008 Dec 16;149(12):889-97. doi: 10.7326/0003-4819-149-12-200812160-00008.


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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Diagnostic Tests, Routine / standards*
  • Humans
  • Information Storage and Retrieval
  • Meta-Analysis as Topic
  • ROC Curve
  • Research Design / standards
  • Review Literature as Topic*
  • Sensitivity and Specificity