Bayesian meta-analysis of the accuracy of a test for tuberculous pleuritis in the absence of a gold standard reference.

ABSTRACT: Absence of a perfect reference test is an acknowledged source of bias in diagnostic studies. In the case of tuberculous pleuritis, standard reference tests such as smear microscopy, culture and biopsy have poor sensitivity. Yet meta-analyses of new tests for this disease have always assumed the reference standard is perfect, leading to biased estimates of the new test's accuracy. We describe a method for joint meta-analysis of sensitivity and specificity of the diagnostic test under evaluation, while considering the imperfect nature of the reference standard. We use a Bayesian hierarchical model that takes into account within- and between-study variability. We show how to obtain pooled estimates of sensitivity and specificity, and how to plot a hierarchical summary receiver operating chara

SUBMITTER: Dendukuri N 

PROVIDER: S-EPMC3728030 | biostudies-literature | 2012 Dec

REPOSITORIES: biostudies-literature