Best practices for MRI systematic reviews and metaâ analyses

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149543/1/jmri26198.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149543/2/jmri26198_am.pd

Preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts):checklist, explanation, and elaboration

For many users of the biomedical literature, abstracts may be the only source of information about a study. Hence, abstracts should allow readers to evaluate the objectives, key design features, and main results of the study. Several evaluations have shown deficiencies in the reporting of journal and conference abstracts across study designs and research fields, including systematic reviews of diagnostic test accuracy studies. Incomplete reporting compromises the value of research to key stakeholders. The authors of this article have developed a 12 item checklist of preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts). This article presents the checklist, examples of complete reporting, and explanations for each item of PRISMA-DTA for Abstracts

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

Meta-Analyses of Diagnostic Accuracy in Imaging Journals: Analysis of Pooling Techniques and Their Effect on Summary Estimates of Diagnostic Accuracy

Purpose To determine whether authors of systematic reviews of diagnostic accuracy studies published in imaging journals used recommended methods for meta-analysis, and to evaluate the effect of traditional methods on summary estimates of sensitivity and specificity. Materials and Methods Medline was searched for published systematic reviews that included meta-analysis of test accuracy data limited to imaging journals published from January 2005 to May 2015. Two reviewers independently extracted study data and classified methods for meta-analysis as traditional (univariate fixed- or random-effects pooling or summary receiver operating characteristic curve) or recommended (bivariate model or hierarchic summary receiver operating characteristic curve). Use of methods was analyzed for variation with time, geographical location, subspecialty, and journal. Results from reviews in which study authors used traditional univariate pooling methods were recalculated with a bivariate model. Results Three hundred reviews met the inclusion criteria, and in 118 (39%) of those, authors used recommended meta-analysis methods. No change in the method used was observed with time (r = 0.54, P = .09); however, there was geographic (χ(2) = 15.7, P = .001), subspecialty (χ(2) = 46.7, P < .001), and journal (χ(2) = 27.6, P < .001) heterogeneity. Fifty-one univariate random-effects meta-analyses were reanalyzed with the bivariate model; the average change in the summary estimate was -1.4% (P < .001) for sensitivity and -2.5% (P < .001) for specificity. The average change in width of the confidence interval was 7.7% (P < .001) for sensitivity and 9.9% (P ≤ .001) for specificity. Conclusion Recommended methods for meta-analysis of diagnostic accuracy in imaging journals are used in a minority of reviews; this has not changed significantly with time. Traditional (univariate) methods allow overestimation of diagnostic accuracy and provide narrower confidence intervals than do recommended (bivariate) methods. (©) RSNA, 2016 Online supplemental material is available for this articl

Treatment of multiple test readers in diagnostic accuracy systematic reviews-meta-analyses of imaging studies

Objective: To evaluate the handling of multiple readers in imaging diagnostic accuracy systematic reviews-metaanalyses. Methods: Search was performed for imaging diagnostic accuracy systematic reviews that performed metaanalysis from 2005-2015. Handling of multiple readers was classified as: 1) averaged; 2) `best' reader; 3) `most experienced' reader; 4) each reader counted individually; 5) random; 6) other; 7) not specified. Incidence and reporting of multiple reader data was assessed in primary diagnostic accuracy studies that were included in a random sample of reviews. Results: Only 28/296 (9.5%) meta-analyses specified how multiple readers were handled: 7/28 averaged results, 2/28 included the best reader, 14/28 treated each reader as a separate data set, 1/28 randomly selected a reader, 4/28 used other methods. Sample of 27/268 ` not specified' reviews generated 442 primary studies. 270/442 (61%) primary studies had multiple readers: 164/442 (37%) reported consensus reading, 87/442 (20%) reported inter-observer variability, 9/442 (2%) reported independent datasets for each reader. 26/27 (96%) meta-analyses contained at least one primary study with multiple readers. Conclusions: Reporting how multiple readers were treated in imaging systematic reviews-meta-analyses is uncommon and method used varied widely. This may result from a lack of guidance, unavailability of appropriate statistical methods for handling multiple readers in meta-analysis, and sub-optimal primary study reportin

Overinterpretation of Research Findings: Evidence of "Spin" in Systematic Reviews of Diagnostic Accuracy Studies

We wished to assess the frequency of overinterpretation in systematic reviews of diagnostic accuracy studies. 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. 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%). 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 recommendation

Selective citation practices in imaging research: Are diagnostic accuracy studies with positive titles and conclusions cited more often?

OBJECTIVE. The purpose of this study was to examine the existence of selective citation practices in the imaging literature by assessing whether diagnostic accuracy studies with positive titles or conclusions are cited more frequently than those with negative (or neutral) titles or conclusions. MATERIALS AND METHODS. MEDLINE was searched for meta-analyses of diagnostic accuracy studies published in imaging journals from January 2005 to April 2016. Primary studies from the meta-analyses were screened for eligibility. Titles and conclusions were classified independently in duplicate. A negative binomial regression analysis controlling for several confounding variables was performed to obtain regression coefficients; p values were obtained via likelihood ratio testing. RESULTS. A total of 995 primary studies were included. Fifty-one titles (5.1%) and 782 conclusions (78.6%) were positive or positive with qualifiers; 942 titles (94.7%) and 127 conclusions (12.8%) were neutral; and two titles (0.02%) and 86 conclusions (8.6%) were negative. Studies with positive, neutral, and negative titles were cited a mean of 0.66, 0.50, and 0.06 times per month. Studies with positive, neutral, and negative conclusions were cited a mean of 0.54, 0.42, and 0.34 times per month. Regression coefficients were 1.10 (95% CI, –0.08 to 2.20) and 0.91 (95% CI, –0.27 to 2.00) for positive and neutral titles, relative to negative titles. Regression coefficients were 0.19 (95% CI, 0.03–0.35) and 0.08 (95% CI, –0.12 to 0.27) for positive and neutral conclusions, relative to negative conclusions. Title and conclusion positivity demonstrated positive association with citation rate (p = 0.031 for both). CONCLUSION. Studies with positive titles or conclusions are cited more frequently in imaging diagnostic accuracy literature. This difference may contribute to overestimation of the accuracy of a test and, consequently, suboptimal patient outcomes

Recommendations for reporting of systematic reviews and meta-analyses of diagnostic test accuracy: a systematic review

Abstract Background This study is to perform a systematic review of existing guidance on quality of reporting and methodology for systematic reviews of diagnostic test accuracy (DTA) in order to compile a list of potential items that might be included in a reporting guideline for such reviews: Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy (PRISMA-DTA). Methods Study protocol published on EQUATOR website. Articles in full text or abstract form that reported on any aspect of reporting systematic reviews of diagnostic test accuracy were eligible for inclusion. We used the Ovid platform to search Ovid MEDLINE®, Ovid MEDLINE® In-Process & Other Non-Indexed Citations and Embase Classic+Embase through May 5, 2016. The Cochrane Methodology Register in the Cochrane Library (Wiley version) was also searched. Title and abstract screening followed by full-text screening of all search results was performed independently by two investigators. Guideline organization websites, published guidance statements, and the Cochrane Handbook for Diagnostic Test Accuracy were also searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Standards for Reporting Diagnostic Accuracy (STARD) were assessed independently by two investigators for relevant items. Results The literature searched yielded 6967 results; 386 were included after title and abstract screening and 203 after full-text screening. After reviewing the existing literature and guidance documents, a preliminary list of 64 items was compiled into the following categories: title (three items); introduction (two items); methods (35 items); results (13 items); discussion (nine items), and disclosure (two items). Conclusion Items on the methods and reporting of DTA systematic reviews in the present systematic review will provide a basis for generating a PRISMA extension for DTA systematic reviews