A composite likelihood method for bivariate meta-analysis in diagnostic systematic reviews

Stat Methods Med Res. 2017 Apr;26(2):914-930. doi: 10.1177/0962280214562146. Epub 2014 Dec 14.


Diagnostic systematic review is a vital step in the evaluation of diagnostic technologies. In many applications, it involves pooling pairs of sensitivity and specificity of a dichotomized diagnostic test from multiple studies. We propose a composite likelihood (CL) method for bivariate meta-analysis in diagnostic systematic reviews. This method provides an alternative way to make inference on diagnostic measures such as sensitivity, specificity, likelihood ratios, and diagnostic odds ratio. Its main advantages over the standard likelihood method are the avoidance of the nonconvergence problem, which is nontrivial when the number of studies is relatively small, the computational simplicity, and some robustness to model misspecifications. Simulation studies show that the CL method maintains high relative efficiency compared to that of the standard likelihood method. We illustrate our method in a diagnostic review of the performance of contemporary diagnostic imaging technologies for detecting metastases in patients with melanoma.

Keywords: Bivariate generalized linear mixed effects model; composite likelihood; diagnostic accuracy; diagnostic review; meta-analysis.

Publication types

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

MeSH terms

  • Analysis of Variance
  • Biostatistics / methods
  • Computer Simulation
  • Diagnostic Tests, Routine / statistics & numerical data*
  • Humans
  • Likelihood Functions*
  • Linear Models
  • Melanoma / diagnostic imaging
  • Melanoma / secondary
  • Meta-Analysis as Topic*
  • Odds Ratio
  • Sensitivity and Specificity
  • Skin Neoplasms / diagnostic imaging