TY - JOUR
T1 - How to Critically Appraise and Interpret Systematic Reviews and Meta-Analyses of Diagnostic Accuracy
T2 - A User Guide
AU - Frank, Robert A.
AU - Salameh, Jean-Paul
AU - Islam, Nayaar
AU - Yang, Bada
AU - Murad, Mohammad Hassan
AU - Mustafa, Reem
AU - Leeflang, Mariska
AU - Bossuyt, Patrick M.
AU - Takwoingi, Yemisi
AU - Whiting, Penny
AU - Dawit, Haben
AU - Kang, Stella K.
AU - Ebrahimzadeh, Sanam
AU - Levis, Brooke
AU - Hutton, Brian
AU - McInnes, Matthew D. F.
N1 - Publisher Copyright: © RSNA, 2023.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Systematic reviews of diagnostic accuracy studies can provide the best available evidence to inform decisions regarding the use of a diagnostic test. In this guide, the authors provide a practical approach for clinicians to appraise diagnostic accuracy systematic reviews and apply their results to patient care. The first step is to identify an appropriate systematic review with a research question matching the clinical scenario. The user should evaluate the rigor of the review methods to evaluate its credibility (Did the review use clearly defined eligibility criteria, a comprehensive search strategy, structured data collection, risk of bias and applicability appraisal, and appropriate meta-analysis methods?). If the review is credible, the next step is to decide whether the diagnostic performance is adequate for clinical use (Do sensitivity and specificity estimates exceed the threshold that makes them useful in clinical practice? Are these estimates sufficiently precise? Is variability in the estimates of diagnostic accuracy across studies explained?). Diagnostic accuracy systematic reviews that are judged to be credible and provide diagnostic accuracy estimates with sufficient certainty and relevance are the most useful to inform patient care. This review discusses comparative, noncomparative, and emerging approaches to systematic reviews of diagnostic accuracy using a clinical scenario and examples based on recent publications.
AB - Systematic reviews of diagnostic accuracy studies can provide the best available evidence to inform decisions regarding the use of a diagnostic test. In this guide, the authors provide a practical approach for clinicians to appraise diagnostic accuracy systematic reviews and apply their results to patient care. The first step is to identify an appropriate systematic review with a research question matching the clinical scenario. The user should evaluate the rigor of the review methods to evaluate its credibility (Did the review use clearly defined eligibility criteria, a comprehensive search strategy, structured data collection, risk of bias and applicability appraisal, and appropriate meta-analysis methods?). If the review is credible, the next step is to decide whether the diagnostic performance is adequate for clinical use (Do sensitivity and specificity estimates exceed the threshold that makes them useful in clinical practice? Are these estimates sufficiently precise? Is variability in the estimates of diagnostic accuracy across studies explained?). Diagnostic accuracy systematic reviews that are judged to be credible and provide diagnostic accuracy estimates with sufficient certainty and relevance are the most useful to inform patient care. This review discusses comparative, noncomparative, and emerging approaches to systematic reviews of diagnostic accuracy using a clinical scenario and examples based on recent publications.
UR - http://www.scopus.com/inward/record.url?scp=85153803619&partnerID=8YFLogxK
U2 - https://doi.org/10.1148/radiol.221437
DO - https://doi.org/10.1148/radiol.221437
M3 - Article
C2 - 36916896
SN - 0033-8419
VL - 307
SP - e221437
JO - Radiology
JF - Radiology
IS - 3
M1 - e221437
ER -