TY  - JOUR
U1  - Zeitschriftenartikel, wissenschaftlich - begutachtet (reviewed)
A1  - Frömke, Cornelia
A1  - Kirstein, Mathia
A1  - Zapf, Antonia
T1  - A semiparametric approach for meta-analysis of diagnostic accuracy studies with multiple cut-offs
JF  - Research Synthesis Methods
N2  - The accuracy of a diagnostic test is often expressed using a pair of measures: sensitivity (proportion of test positives among all individuals with target condition) and specificity (proportion of test negatives among all individuals without targetcondition). If the outcome of a diagnostic test is binary, results from different studies can easily be summarized in a meta-analysis. However, if the diagnostic test is based on a discrete or continuous measure (e.g., a biomarker), several cut-offs within one study as well as among different studies are published. Instead of taking all information of the cut-offs into account in the meta-analysis, a single cut-off per study is often selected arbitrarily for the analysis, even though there are statistical methods for the incorporation of several cut-offs. For these methods, distributional assumptions have to be met and/or the models may not converge when specific data structures occur. We propose a semiparametric approach to overcome both problems. Our simulation study shows that the diagnostic accuracy is underestimated, although this underestimation in sensitivity and specificity is relatively small. The comparative approach of Steinhauser et al. is better in terms of coverage probability, but may lead to convergence problems. In addition to the simulation results, we illustrate the application of the semiparametric approach using a published meta-analysis for a diagnostic test differentiating between bacterial and viral meningitis in children.
KW  - diagnostic accuracy studies
KW  - meta-analysis
KW  - multiple cut-offs
KW  - semiparametric
Y1  - 2022
UN  - https://nbn-resolving.org/urn:nbn:de:bsz:960-opus4-24365
SN  - 1759-2887
SS  - 1759-2887
U6  - https://doi.org/10.25968/opus-2436
DO  - https://doi.org/10.25968/opus-2436
VL  - 13
SP  - 612
EP  - 621
ER  -