ArticleSystematic reviews2021
Application of weighting methods for presenting risk-of-bias assessments in systematic reviews of diagnostic test accuracy studies.
Article in Systematic reviews, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 4 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Chronic kidney disease in adults with sickle cell trait: a systematic review and meta-analysis.Blood advances · 2025Pooled it
- Effectiveness of workplace health promotion programs for industrial workers: a systematic review.BMC public health · 2025Pooled it
- A meta-analysis investigating the outcomes and correlation between heart rate variability biofeedback training on depressive symptoms and heart rate variability outcomes versus standard treatment in comorbid adult populations.Acta bio-medica : Atenei Parmensis · 2023Pooled it
- A Systematic Review of Recreational Nitrous Oxide Use: Implications for Policy, Service Delivery and Individuals.International journal of environmental research and public health · 2022Pooled it
- Diagnostic value of congenital hypertrophy of the retinal pigment epithelium in familial adenomatous polyposis: a systematic review.International journal of retina and vitreous · 2026Review
- SciRAPepi Tool: Optimization of the SciRAP Tool for Evaluating the Reliability and Relevance of Observational Epidemiological Studies for Hazard and Risk Assessment of Chemicals.Environmental science & technology · 2026Article
- Clinical Outcomes of 3D-Printed Titanium Patient-Specific Implants in Lumbar Interbody Fusion: A Prospective Clinical Trial with a Systematic Review of Conventional Techniques.Journal of personalized medicine · 2025Article
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAn assessment of the validity of individual diagnostic accuracy studies in systematic reviews is necessary to guide the analysis and the interpretation of results. Such an assessment is performed for each included study and typically reported at the study level. As studies may differ in sample size and disease prevalence, with larger studies contributing more to the meta-analysis, such a study-level report does not always reflect the risk of bias in the total body of evidence. We aimed to develop improved methods of presenting the risk of bias in the available evidence on diagnostic accuracy of medical tests in systematic reviews, reflecting the relative contribution of the study to the body of evidence in the review.
methodsWe applied alternative methods to represent evaluations with the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2), weighting studies according to their relative contribution to the total sample size or their relative effective sample size. We used these methods in four existing systematic reviews of diagnostic accuracy studies, including 9, 13, 22, and 32 studies, respectively.
resultsThe risk-of-bias summaries for each domain of the QUADAS-2 checklist changed in all four sets of studies after replacing unit weights for the studies with relative sample sizes or with the relative effective sample size. As an example, the risk of bias was high in the patient selection domain in 31% of the studies in one review, unclear in 23% and low in 46% of studies. Weighting studies according to the relative sample size changed the corresponding proportions to 4%, 4%, and 92%, respectively. The difference between the two weighting methods was small and more noticeable when the reviews included a smaller number of studies with wider range of sample size.
conclusionsWe present an alternative way of presenting the results of risk-of-bias assessments in systematic reviews of diagnostic accuracy studies. Weighting studies according to their relative sample size or their relative effective sample size can be used as more informative summaries of the risk of bias in the total body of available evidence. SYSTEMATIC REVIEW REGISTRATIONS: Not applicable.
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