TOMAS-R: A template to identify and plan analysis for clinically important variation and multiplicity in diagnostic test accuracy systematic reviews

Diagnostic and Prognostic Research - Tập 6 Số 1
Susan Mallett1, Jacqueline Dinnes2, Yemisi Takwoingi2, Lavinia Ferrante di Ruffano3,4
1UCL Centre for Medical Imaging, University College London, London, UK
2NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
3Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
4York Health Economics Consortium, Enterprise House, Innovation Way, University of York, York, UK

Tóm tắt

AbstractThe Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy (DTA) provides guidance on important aspects of conducting a test accuracy systematic review. In this paper we present TOMAS-R (Template of Multiplicity and Analysis in Systematic Reviews), a structured template to use in conjunction with current Cochrane DTA guidance, to help identify complexities in the review question and to assist planning of data extraction and analysis when clinically important variation and multiplicity is present. Examples of clinically important variation and multiplicity could include differences in participants, index tests and test methods, target conditions and reference standards used to define them, study design and methodological quality. Our TOMAS-R template goes beyond the broad topic headings in current guidance that are sources of potential variation and multiplicity, by providing prompts for common sources of heterogeneity encountered from our experience of authoring over 100 reviews. We provide examples from two reviews to assist users. The TOMAS-R template adds value by supplementing available guidance for DTA reviews by providing a tool to facilitate discussions between methodologists, clinicians, statisticians and patient/public team members to identify the full breadth of review question complexities early in the process. The use of a structured set of prompting questions at the important stage of writing the protocol ensures clinical relevance as a main focus of the review, while allowing identification of key clinical components for data extraction and later analysis thereby facilitating a more efficient review process.

Từ khóa


Tài liệu tham khảo

Oxman AD, Guyatt GH. The science of reviewing research. Ann N Y Acad Sci. 1993;703:125–33 discussion 133-124.

Bossuyt PMM. Chapter 4: Understanding the design of test accuracy studies. In: Deeks JJ, PMMB, Leeflang MMG, Takwoingi Y, editors. 2022.

Deeks JJ, Wisniewski S, Davenport C. Chapter 4: Guide to the contents of a Cochrane Diagnostic Test Accuracy Protocol. In: Deeks JJ, Bossuyt PMM, Gatsonis C, editors. 2013.

Leeflang MMG, Davenport C, Bossuyt PMM: Chapter 6: Defining the review question. In: Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy Edited by Deeks JJ, Bossuyt PMM, Leeflang MMG, Takwoingi Y. London: Cochrane; 2022.

Macaskill P, Takwoingi Y, Deeks JJ, Gatsonis C. Chapter 10: Understanding meta-analysis. In: Deeks JJ, PMM B, Leeflang MMG, Takwoingi Y, editors. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. London: Cochrane; 2022.

Cochrane Screening and Diagnostic Tests Methods Group (SDTM). https://methods.cochrane.org/sdt. Accessed 21 July 2022.

Wijedoru L, Mallett S, Parry CM. Rapid diagnostic tests for typhoid and paratyphoid (enteric) fever. Cochrane Database Syst Rev. 2017;5:CD008892.

Rai N, Champaneria R, Snell K, Mallett S, Bayliss SE, Neal RD, et al. Symptoms, ultrasound imaging and biochemical markers alone or in combination for the diagnosis of ovarian cancer in women with symptoms suspicious of ovarian cancer. Cochrane Database Syst Rev. 2015. https://doi.org/10.1002/14651858.CD011964.

Steinhauser S, Schumacher M, Rucker G. Modelling multiple thresholds in meta-analysis of diagnostic test accuracy studies. BMC Med Res Methodol. 2016;16(1):97.

Jones HE, Gatsonsis CA, Trikalinos TA, Welton NJ, Ades AE. Quantifying how diagnostic test accuracy depends on threshold in a meta-analysis. Stat Med. 2019;38(24):4789–803.

Whiting PF, Rutjes AW, Westwood ME, Mallett S, Deeks JJ, Reitsma JB, et al. Group Q-: QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529–36.

Yang B, Mallett S, Takwoingi Y, Davenport CF, Hyde CJ, Whiting PF, et al. QUADAS-C: A Tool for Assessing Risk of Bias in Comparative Diagnostic Accuracy Studies. Ann Intern Med. 2021;174(11):1592–9.

Halligan S, Altman DG, Taylor SA, Mallett S, Deeks JJ, Bartram CI, et al. CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology. 2005;237(3):893–904.

Takwoingi Y, Dendukuri N, Schiller I, Rücker G, Jones HE, Partlett C, et al. Chapter 11: Undertaking meta-analysis. In: Deeks JJ, Bossuyt PMM, Leeflang MMG, Takwoingi Y, editors. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. London: Cochrane; 2022.

Ma X, Lian Q, Chu H, Ibrahim JG, Chen Y. A Bayesian hierarchical model for network meta-analysis of multiple diagnostic tests. Biostatistics. 2018;19(1):87–102.

Owen RK, Cooper NJ, Quinn TJ, Lees R, Sutton AJ. Network meta-analysis of diagnostic test accuracy studies identifies and ranks the optimal diagnostic tests and thresholds for health care policy and decision-making. J Clin Epidemiol. 2018;99:64–74.

Takwoingi Y, Partlett C, Riley RD, Hyde C, Deeks JJ. Methods and reporting of systematic reviews of comparative accuracy were deficient: a methodological survey and proposed guidance. J Clin Epidemiol. 2020;121:1–14.

Takwoingi Y, Leeflang MM, Deeks JJ. Empirical evidence of the importance of comparative studies of diagnostic test accuracy. Ann Intern Med. 2013;158(7):544–54.

Dinnes J, Deeks JJ, Leeflang MMG, Li T. Chapter 9: Collecting data. In: Deeks JJ, Bossuyt PMM, Leeflang MMG, Takwoingi Y, editors. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. London: Cochrane; 2022.

Halligan S, Boone D, Bhatnagar G, Ahmad T, Bloom S, Rodriguez-Justo M, et al. Prognostic biomarkers to identify patients destined to develop severe Crohn's disease who may benefit from early biological therapy: protocol for a systematic review, meta-analysis and external validation. Syst Rev. 2016;5(1):206.

Thông tin
Thông tin xuất bản

Diagnostic and Prognostic Research

Tập 6 Số 1

Thông tin tác giả