Trevor A McGrath1, Matthew D F McInnes2, Nick van Es3, Mariska M G Leeflang4, Daniël A Korevaar4, Patrick M M Bossuyt4. 1. University of Ottawa, Ottawa, Ontario, Canada. 2. University of Ottawa Department of Radiology. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; mmcinnes@toh.on.ca. 3. Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands. 4. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center Amsterdam, the Netherlands.
Abstract
BACKGROUND: We wished to assess the frequency of overinterpretation in systematic reviews of diagnostic accuracy studies. METHODS: MEDLINE was searched through PubMed from December 2015 to January 2016. Systematic reviews of diagnostic accuracy studies in English were included if they reported one or more metaanalyses of accuracy estimates. We built and piloted a list of 10 items that represent actual overinterpretation in the abstract and/or full-text conclusion, and a list of 9 items that represent potential overinterpretation. Two investigators independently used the items to score each included systematic review, with disagreements resolved by consensus. RESULTS: We included 112 systematic reviews. The majority had a positive conclusion regarding the accuracy or clinical usefulness of the investigated test in the abstract (n = 83; 74%) and full-text (n = 83; 74%). Of the 112 reviews, 81 (72%) contained at least 1 actual form of overinterpretation in the abstract, and 77 (69%) in the full-text. This was most often a "positive conclusion, not reflecting the reported summary accuracy estimates," in 55 (49%) abstracts and 56 (50%) full-texts and a "positive conclusion, not taking high risk of bias and/or applicability concerns into account," in 47 abstracts (42%) and 26 full-texts (23%). Of these 112 reviews, 107 (96%) contained a form of potential overinterpretation, most frequently "nonrecommended statistical methods for metaanalysis performed" (n = 57; 51%). CONCLUSIONS: Most recent systematic reviews of diagnostic accuracy studies present positive conclusions and a majority contain a form of overinterpretation. This may lead to unjustified optimism about test performance and erroneous clinical decisions and recommendations.
BACKGROUND: We wished to assess the frequency of overinterpretation in systematic reviews of diagnostic accuracy studies. METHODS: MEDLINE was searched through PubMed from December 2015 to January 2016. Systematic reviews of diagnostic accuracy studies in English were included if they reported one or more metaanalyses of accuracy estimates. We built and piloted a list of 10 items that represent actual overinterpretation in the abstract and/or full-text conclusion, and a list of 9 items that represent potential overinterpretation. Two investigators independently used the items to score each included systematic review, with disagreements resolved by consensus. RESULTS: We included 112 systematic reviews. The majority had a positive conclusion regarding the accuracy or clinical usefulness of the investigated test in the abstract (n = 83; 74%) and full-text (n = 83; 74%). Of the 112 reviews, 81 (72%) contained at least 1 actual form of overinterpretation in the abstract, and 77 (69%) in the full-text. This was most often a "positive conclusion, not reflecting the reported summary accuracy estimates," in 55 (49%) abstracts and 56 (50%) full-texts and a "positive conclusion, not taking high risk of bias and/or applicability concerns into account," in 47 abstracts (42%) and 26 full-texts (23%). Of these 112 reviews, 107 (96%) contained a form of potential overinterpretation, most frequently "nonrecommended statistical methods for metaanalysis performed" (n = 57; 51%). CONCLUSIONS: Most recent systematic reviews of diagnostic accuracy studies present positive conclusions and a majority contain a form of overinterpretation. This may lead to unjustified optimism about test performance and erroneous clinical decisions and recommendations.
Authors: Trevor A McGrath; Robert A Frank; Nicola Schieda; Brian Blew; Jean-Paul Salameh; Patrick M M Bossuyt; Matthew D F McInnes Journal: Eur Radiol Date: 2020-01-24 Impact factor: 5.315
Authors: Lee Treanor; Robert A Frank; Lindsay A Cherpak; Ana Dehmoobad Sharifabadi; Jean-Paul Salameh; Zachary Hallgrimson; Nicholas Fabiano; Trevor A McGrath; Noemie Kraaijpoel; Jason Yao; Daniel A Korevaar; Patrick M Bossuyt; Matthew D F McInnes Journal: Eur Radiol Date: 2020-01-17 Impact factor: 5.315
Authors: Trevor A McGrath; Mostafa Alabousi; Becky Skidmore; Daniël A Korevaar; Patrick M M Bossuyt; David Moher; Brett Thombs; Matthew D F McInnes Journal: Syst Rev Date: 2017-10-10