Estimating Diagnostic Accuracy from Multiple Conflicting Reports

Abstract

Reports of diagnostic accuracy often differ. The authors present a method to summarize disparate reports that uses a logistic transformation and linear regression to produce a summary receiver operating characteristic curve. The curve is useful for summarizing a body of diagnostic accuracy literature, comparing technologies, detecting outliers, and finding the optimum operating point of the test. Examples from clinical chemistry and diagnostic radiology are provided. By extending the logic of meta-analysis to diagnostic testing, the method provides a new tool for technology assessment. Key words: meta-analysis; sensitivity and specificity; decision support; data interpretation, statistical; regression analysis; diagnostic accuracy. (Med Decis Making 1993;13:313-321)