Evidence map›Paper›PMID 27485293›Full record

ArticleJournal of clinical epidemiology2016

The Moses-Littenberg meta-analytical method generates systematic differences in test accuracy compared to hierarchical meta-analytical models.

Jacqueline Dinnes, Susan Mallett, Sally Hopewell, Paul J Roderick, Jonathan J Deeks

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Article in Journal of clinical epidemiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Guideline
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  6. Electrical conductance for the detection of dental caries.The Cochrane database of systematic reviews · 2021
    Pooled it
  7. Imaging modalities to inform the detection and diagnosis of early caries.The Cochrane database of systematic reviews · 2021
    Pooled it
  8. Pooled it
  9. Fluorescence devices for the detection of dental caries.The Cochrane database of systematic reviews · 2020
    Pooled it
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  11. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jacqueline DinnesBiostatistics, Evidence Synthesis and Test Evaluation Research Group, Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Susan MallettBiostatistics, Evidence Synthesis and Test Evaluation Research Group, Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Sally HopewellCentre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford/Botnar Research Centre, Windmill Road, Oxford OX3 7LD, UK.
Paul J RoderickDepartment of Public Health Sciences and Medical Statistics, University of Southampton, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
Jonathan J DeeksBiostatistics, Evidence Synthesis and Test Evaluation Research Group, Institute for Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: j.deeks@bham.ac.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare meta-analyses of diagnostic test accuracy using the Moses-Littenberg summary receiver operating characteristic (SROC) approach with those of the hierarchical SROC (HSROC) model. STUDY DESIGN AND

settingTwenty-six data sets from existing test accuracy systematic reviews were reanalyzed with the Moses-Littenberg model, using equal weighting ("E-ML") and weighting by the inverse variance of the log DOR ("W-ML"), and with the HSROC model. The diagnostic odds ratios (DORs) were estimated and covariates added to both models to estimate relative DORs (RDORs) between subgroups. Models were compared by calculating the ratio of DORs, the ratio of RDORs, and P-values for detecting asymmetry and effects of covariates on DOR.

resultsCompared to the HSROC model, the Moses-Littenberg model DOR estimates were a median of 22% ("E-ML") and 47% ("W-ML") lower at Q*, and 7% and 42% lower at the central point in the data. Instances of the ML models giving estimates higher than the HSROC model also occurred. Investigations of heterogeneity also differed; the Moses-Littenberg models on average estimating smaller differences in RDOR.

conclusionsMoses-Littenberg meta-analyses can generate lower estimates of test accuracy, and smaller differences in accuracy, compared to mathematically superior hierarchical models. This has implications for the usefulness of meta-analyses using this approach. We recommend meta-analysis of diagnostic test accuracy studies to be conducted using available hierarchical model-based approaches.

Indexed as

Meta-Analysis as TopicReproducibility of ResultsDiagnostic Tests, RoutineHumansOdds RatioROC CurveDiagnostic odds ratioDiagnostic test accuracyHierarchical modelsMeta-analysisSummary ROC curvesSystematic review

Identifiers

PMID27485293
PMCPMC5176007

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.