Wednesday, November 25, 2020

Diagnostic Test Accuracy Meta-Analyses Are Often Missing Information Required for Reproducibility

Reproducibility of results is considered a key tenet of the scientific process. When results of a study are reproduced by others using the same protocol, there is less chance that the original results observed were due human or random error. Testing the reproducibility of evidence syntheses (e.g., meta-analyses) is just as important as for individual trials.

In a paper published earlier this month, Stegeman and Leeflang undertook the task of testing the reproducibility of meta-analyses of diagnostic test accuracy. The authors identified 51 eligible meta-analyses published in January 2018. In 19 of these, sufficient information was provided in the text of the study to reproduce the 2x2 tables of the individual studies included; in the remaining 32, only estimates were provided in the text. In 17 of these 32, the authors located primary data to attempt reproducibility. When attempting to reproduce the meta-analyses of the 51 identified papers, reproducibility was only achieved 28% of the time; none of the 17 papers for which 2x2 tables were not provided were reproducible.

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Only 14 (27%) of the 51 articles provided full search terms. In nearly half (25) of the included reviews, at least one of the full texts of included references could not be located; in 12, at least one title or abstract could not be located. Overall, of the 51 included reviews, only one was deemed fully reproducible by providing a full protocol, 2x2 tables, and the same summary estimates as the authors.

The authors conclude with a call for increased prospective registration of protocols and improved reporting of search terms and methods. The application of the 2017 PRISMA statement for diagnostic test accuracy is a helpful tool for any aspiring author of a diagnostic test accuracy meta-analysis to improve the reporting and reproducibility of results.

Stegeman I. and Leeflang M.M.G. (2020). Meta-analyses of diagnostic test accuracy could not be reproduced. J Clin Epidemiol 127:161-166.

Manuscript available at the publisher's website here