Comparative Effectiveness Research Using Meta-Analysis to Evaluate and Summarize Diagnostic Accuracy

• Activity Number: 421
• Type: Topic Contributed
• Date/Time: Tuesday, August 6, 2013 : 2:00 PM to 3:50 PM
• Sponsor: Biopharmaceutical Section
• Author(s): Kelly Zou*+ and Ching-Ray Yu and Ye Tan and Martin O. Carlsson
• Companies: Pfizer Inc and Pfizer Inc and Pfizer Inc and Pfizer Inc
• Keywords: Comparative Effectiveness Research ; Meta-Analysis ; Sensitivity ; Specificity ; Diagnostic Odds Ratio ; Summary Receiver Operating Characteristic Curve

Abstract

According to the Agency for Healthcare Research and Quality, "comparative effectiveness research is designed to inform health-care decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, or ways to deliver health care." Since it is difficult to systematically review each study to generate the best evidence and practice based on the overall diagnostic accuracy, it is useful to conduct a meta-analysis of such studies. In this comparative effectiveness research, our main aim is to synthesize and combine studies that yield proportions in a two-sample setting according to a reference standard. Statistical methods are developed to combine sensitivities (i.e., true positive fraction), specificities (i.e., true negative fraction), and diagnostic odds ratios. A summary ROC curve is also constructed. Various weighting schemes are considered across study-level data. For illustration purposes, a publically-available example is provided.