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OBJECTIVES: To assess the methods and reporting of systematic reviews of diagnostic tests. DATA SOURCES: Systematic searches of Medline, Embase, and five other databases identified reviews of tests used in patients with cancer. Of these, 89 satisfied our inclusion criteria of reporting accuracy of the test compared with a reference test, including an electronic search, and published since 1990. REVIEW METHODS: All reviews were assessed for methods and reporting of objectives, search strategy, participants, clinical setting, index and reference tests, study design, study results, graphs, meta-analysis, quality, bias, and procedures in the review. We assessed 25 randomly selected reviews in more detail. RESULTS: 75% (67) of the reviews stated inclusion criteria, 49% (44) tabulated characteristics of included studies, 40% (36) reported details of study design, 17% (15) reported on the clinical setting, 17% (15) reported on the severity of disease in participants, and 49% (44) reported on whether the tumours were primary, metastatic, or recurrent. Of the 25 reviews assessed in detail, 68% (17) stated the reference standard used in the review, 36% (9) reported the definition of a positive result for the index test, and 56% (14) reported sensitivity, specificity, and sample sizes for individual studies. Of the 89 reviews, 61% (54) attempted to formally synthesise results of the studies and 32% (29) reported formal assessments of study quality. CONCLUSIONS: Reliability and relevance of current systematic reviews of diagnostic tests is compromised by poor reporting and review methods.

Type

Journal article

Journal

BMJ (Clinical research ed.)

Publication Date

08/2006

Volume

333

Addresses

Centre for Statistics in Medicine, University of Oxford, Wolfson College, Oxford OX2 6UD. susan.mallett@cancer.org.uk

Keywords

Humans, Neoplasms, Diagnostic Techniques and Procedures, Reproducibility of Results, Bias (Epidemiology), Review Literature as Topic, Meta-Analysis as Topic