Abstract
Diagnosis is a critical step in clinical treatment. Meta-analysis is a useful tool for evaluating the accuracy of diagnostic tests and can be used to obtain precise accuracy estimates when small studies for a given test and subject pool are available. Meta-analysis uses statistical techniques to combine and compare data from different studies, thus increasing the power of the estimates of diagnostic accuracy in primary research. Meta-analysis of diagnostic tests summarizes the accuracy of diagnosis. Therefore, it is necessary for clinicians to understand meta-analytical procedures for diagnostic tests. Herein, we describe the basic steps in a meta-analysis to evaluate test accuracy: 1) describing the results of individual studies, 2) searching for heterogeneity, 3) testing for the threshold effect, 4) deciding on the model for statistical pooling, 5) dealing with heterogeneity, and 6) interpreting meta-analysis results of diagnostic tests. Meta-analysis of diagnostic test accuracy provides useful information for clinical practice and for the formulation of questions to be tested in future studies.
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