To evaluate changes over time in summary estimates from meta-analyses of diagnostic accuracy studies.
Study Design and Setting
We included 48 meta-analyses from 35 MEDLINE-indexed systematic reviews published between September 2011 and January 2012 (743 diagnostic accuracy studies; 344,015 participants). Within each meta-analysis, we ranked studies by publication date. We applied random-effects cumulative meta-analysis to follow how summary estimates of sensitivity and specificity evolved over time. Time trends were assessed by fitting a weighted linear regression model of the summary accuracy estimate against rank of publication.
The median of the 48 slopes was −0.02 (−0.08 to 0.03) for sensitivity and −0.01 (−0.03 to 0.03) for specificity. Twelve of 96 (12.5%) time trends in sensitivity or specificity were statistically significant. We found a significant time trend in at least one accuracy measure for 11 of the 48 (23%) meta-analyses.
Time trends in summary estimates are relatively frequent in meta-analyses of diagnostic accuracy studies. Results from early meta-analyses of diagnostic accuracy studies should be considered with caution.
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Published online: May 19, 2016
Accepted: April 29, 2016
Conflict of interest: None.
Funding: J.F.C. is supported by a research grant from Assistance Publique-Hôpitaux de Paris (Année Médaille de l'Internat 2013).
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