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Comparing outcomes from tailored meta-analysis with outcomes from a setting specific test accuracy study using routine data of faecal calprotectin testing for inflammatory bowel disease
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Freeman, Karoline, Willis, Brian H., Ryan, Ronan, Taylor-Phillips, Sian and Clarke, Aileen (2022) Comparing outcomes from tailored meta-analysis with outcomes from a setting specific test accuracy study using routine data of faecal calprotectin testing for inflammatory bowel disease. BMC Medical Research Methodology, 22 (1). 192. doi:10.1186/s12874-022-01668-9 ISSN 1471-2288.
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Official URL: https://doi.org/10.1186/s12874-022-01668-9
Abstract
Background
Meta-analyses of test accuracy studies may provide estimates that are highly improbable in clinical practice. Tailored meta-analysis produces plausible estimates for the accuracy of a test within a specific setting by tailoring the selection of included studies compatible with a specific setting using information from the target setting. The aim of this study was to validate the tailored meta-analysis approach by comparing outcomes from tailored meta-analysis with outcomes from a setting specific test accuracy study.
Methods
A retrospective cohort study of primary care electronic health records provided setting-specific data on the test positive rate and disease prevalence. This was used to tailor the study selection from a review of faecal calprotectin testing for inflammatory bowel disease for meta-analysis using the binomial method and the Mahalanobis distance method. Tailored estimates were compared to estimates from a study of test accuracy in primary care using the same routine dataset.
Results
Tailoring resulted in the inclusion of 3/14 (binomial method) and 9/14 (Mahalanobis distance method) studies in meta-analysis. Sensitivity and specificity from tailored meta-analysis using the binomial method were 0.87 (95% CI 0.77 to 0.94) and 0.65 (95% CI 0.60 to 0.69) and 0.98 (95% CI 0.83 to 0.999) and 0.68 (95% CI 0.65 to 0.71), respectively using the Mahalanobis distance method. The corresponding estimates for the conventional meta-analysis were 0.94 (95% CI 0.90 to 0.97) and 0.67 (95% CI 0.57 to 0.76) and for the FC test accuracy study of primary care data 0.93 (95%CI 0.89 to 0.96) and 0.61 (95% CI 0.6 to 0.63) to detect IBD at a threshold of 50 μg/g. Although the binomial method produced a plausible estimate, the tailored estimates of sensitivity and specificity were not closer to the primary study estimates than the estimates from conventional meta-analysis including all 14 studies.
Conclusions
Tailored meta-analysis does not always produce estimates of sensitivity and specificity that lie closer to the estimates derived from a primary study in the setting in question. Potentially, tailored meta-analysis may be improved using a constrained model approach and this requires further investigation.
| Item Type: | Journal Article | ||||||||||||
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| Subjects: | Q Science > QP Physiology R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||||||||
| SWORD Depositor: | Library Publications Router | ||||||||||||
| Library of Congress Subject Headings (LCSH): | Inflammatory bowel diseases , Inflammatory bowel diseases -- Diagnosis, Feces -- Analysis , Meta-analysis | ||||||||||||
| Journal or Publication Title: | BMC Medical Research Methodology | ||||||||||||
| Publisher: | BioMed Central | ||||||||||||
| ISSN: | 1471-2288 | ||||||||||||
| Official Date: | 12 July 2022 | ||||||||||||
| Dates: |
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| Volume: | 22 | ||||||||||||
| Number: | 1 | ||||||||||||
| Article Number: | 192 | ||||||||||||
| DOI: | 10.1186/s12874-022-01668-9 | ||||||||||||
| Status: | Peer Reviewed | ||||||||||||
| Publication Status: | Published | ||||||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
| Date of first compliant deposit: | 14 July 2022 | ||||||||||||
| Date of first compliant Open Access: | 15 July 2022 | ||||||||||||
| RIOXX Funder/Project Grant: |
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