Systematic reviews of diagnostic tests in endocrinology: an audit of methods, reporting, and performance

Gabriela Spencer-Bonilla, Naykky Singh Ospina, Rene Rodriguez-Gutierrez, Juan Brito Campana, Nicole Iñiguez-Ariza, Shrikant Tamhane, Patricia J. Erwin, Mohammad H Murad, Victor Manuel Montori

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Systematic reviews provide clinicians and policymakers estimates of diagnostic test accuracy and their usefulness in clinical practice. We identified all available systematic reviews of diagnosis in endocrinology, summarized the diagnostic accuracy of the tests included, and assessed the credibility and clinical usefulness of the methods and reporting. Methods: We searched Ovid MEDLINE, EMBASE, and Cochrane CENTRAL from inception to December 2015 for systematic reviews and meta-analyses reporting accuracy measures of diagnostic tests in endocrinology. Experienced reviewers independently screened for eligible studies and collected data. We summarized the results, methods, and reporting of the reviews. We performed subgroup analyses to categorize diagnostic tests as most useful based on their accuracy. Results: We identified 84 systematic reviews; half of the tests included were classified as helpful when positive, one-fourth as helpful when negative. Most authors adequately reported how studies were identified and selected and how their trustworthiness (risk of bias) was judged. Only one in three reviews, however, reported an overall judgment about trustworthiness and one in five reported using adequate meta-analytic methods. One in four reported contacting authors for further information and about half included only patients with diagnostic uncertainty. Conclusion: Up to half of the diagnostic endocrine tests in which the likelihood ratio was calculated or provided are likely to be helpful in practice when positive as are one-quarter when negative. Most diagnostic systematic reviews in endocrine lack methodological rigor, protection against bias, and offer limited credibility. Substantial efforts, therefore, seem necessary to improve the quality of diagnostic systematic reviews in endocrinology.

Original languageEnglish (US)
Pages (from-to)1-17
Number of pages17
JournalEndocrine
DOIs
StateAccepted/In press - Jun 5 2017

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Endocrinology
Routine Diagnostic Tests
MEDLINE
Uncertainty
Meta-Analysis

Keywords

  • Diagnostic accuracy
  • Diagnostic systematic review
  • Systematic review methodology

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Systematic reviews of diagnostic tests in endocrinology : an audit of methods, reporting, and performance. / Spencer-Bonilla, Gabriela; Singh Ospina, Naykky; Rodriguez-Gutierrez, Rene; Brito Campana, Juan; Iñiguez-Ariza, Nicole; Tamhane, Shrikant; Erwin, Patricia J.; Murad, Mohammad H; Montori, Victor Manuel.

In: Endocrine, 05.06.2017, p. 1-17.

Research output: Contribution to journalArticle

Spencer-Bonilla G, Singh Ospina N, Rodriguez-Gutierrez R, Brito Campana J, Iñiguez-Ariza N, Tamhane S et al. Systematic reviews of diagnostic tests in endocrinology: an audit of methods, reporting, and performance. Endocrine. 2017 Jun 5;1-17. https://doi.org/10.1007/s12020-017-1298-1
Spencer-Bonilla, Gabriela ; Singh Ospina, Naykky ; Rodriguez-Gutierrez, Rene ; Brito Campana, Juan ; Iñiguez-Ariza, Nicole ; Tamhane, Shrikant ; Erwin, Patricia J. ; Murad, Mohammad H ; Montori, Victor Manuel. / Systematic reviews of diagnostic tests in endocrinology : an audit of methods, reporting, and performance. In: Endocrine. 2017 ; pp. 1-17.
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AU - Brito Campana, Juan

AU - Iñiguez-Ariza, Nicole

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AB - Background: Systematic reviews provide clinicians and policymakers estimates of diagnostic test accuracy and their usefulness in clinical practice. We identified all available systematic reviews of diagnosis in endocrinology, summarized the diagnostic accuracy of the tests included, and assessed the credibility and clinical usefulness of the methods and reporting. Methods: We searched Ovid MEDLINE, EMBASE, and Cochrane CENTRAL from inception to December 2015 for systematic reviews and meta-analyses reporting accuracy measures of diagnostic tests in endocrinology. Experienced reviewers independently screened for eligible studies and collected data. We summarized the results, methods, and reporting of the reviews. We performed subgroup analyses to categorize diagnostic tests as most useful based on their accuracy. Results: We identified 84 systematic reviews; half of the tests included were classified as helpful when positive, one-fourth as helpful when negative. Most authors adequately reported how studies were identified and selected and how their trustworthiness (risk of bias) was judged. Only one in three reviews, however, reported an overall judgment about trustworthiness and one in five reported using adequate meta-analytic methods. One in four reported contacting authors for further information and about half included only patients with diagnostic uncertainty. Conclusion: Up to half of the diagnostic endocrine tests in which the likelihood ratio was calculated or provided are likely to be helpful in practice when positive as are one-quarter when negative. Most diagnostic systematic reviews in endocrine lack methodological rigor, protection against bias, and offer limited credibility. Substantial efforts, therefore, seem necessary to improve the quality of diagnostic systematic reviews in endocrinology.

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