Abstract
BackgroundOver the last decade there have been a number of guidelines published, aimed at improving the quality of reporting in published studies and reviews. In systematic reviews this may be measured by their compliance with the PRISMA statement. This review aims to evaluate the quality of reporting in published meta-analyses of diagnostic tests, using the PRISMA statement and establish whether there has been a measurable improvement over time.MethodsEight databases were searched for reviews published prior to 31st December 2008. Studies were selected if they evaluated a diagnostic test, measured performance, searched two or more databases, stated the search terms and inclusion criteria, and used a statistical method to summarise a test's performance. Data were extracted on the review characteristics and items of the PRISMA statement. To measure the change in the quality of reporting over time, PRISMA items for two periods of equal duration were compared.ResultsCompliance with the PRISMA statement was generally poor: none of the reviews completely adhered to all 27 checklist items. Of the 236 meta-analyses included following selection: only 2(1%) reported the study protocol; 59(25%) reported the searches used; 76(32%) reported the results of a risk of bias assessment; and 82(35%) reported the abstract as a structured summary. Only 11 studies were published before 2000. Thus, the impact of QUOROM on the quality of reporting was not evaluated. However, the periods 2001-2004 and 2005-2008 (covering 93% of studies) were compared using relative risks (RR). There was an increase in the proportion of reviews reporting on five PRISMA items: eligibility criteria (RR 1.13, 95% CI 1.00 - 1.27); risk of bias across studies (methods) (RR 1.81, 95% CI 1.34 - 2.44); study selection results (RR 1.48, 95% CI 1.05 - 2.09); results of individual studies (RR 1.37, 95% CI 1.09 - 1.72); risk of bias across studies (results) (RR 1.65, 95% CI 1.20 - 2.25).ConclusionAlthough there has been an improvement in the quality of meta-analyses in diagnostic research, there are still many deficiencies in the reporting which future reviewers need to address if readers are to trust the validity of the reported findings.
Highlights
Conclusion: there has been an improvement in the quality of meta-analyses in diagnostic research, there are still many deficiencies in the reporting which future reviewers need to address if readers are to trust the validity of the reported findings
Systematic reviews have become increasingly important in diagnostic research [1,2]
With the development of new statistical methods used to aggregate primary studies [3,4], and increasing numbers of diagnostic reviews appearing in the literature [1,2], the need for high quality meta-analyses of diagnostic tests has, perhaps, never been greater
Summary
Over the last decade there have been a number of guidelines published, aimed at improving the quality of reporting in published studies and reviews In systematic reviews this may be measured by their compliance with the PRISMA statement. This review aims to evaluate the quality of reporting in published metaanalyses of diagnostic tests, using the PRISMA statement and establish whether there has been a measurable improvement over time. Like all other types of systematic reviews, they are prone to a number of shortcomings These may arise at a review level, due to inaccessibility to all pertinent studies [5], failings in the selection process [6], or heterogeneity [7,8], which often blights reviews of diagnostic tests [2]. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool [12] is a generic tool that covers the major domains affecting diagnostic study validity, placing quality assessment on a firmer ground and allowing inter-study comparison
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