Ensor, J and Deeks, JJ and Martin, EC and Riley, RD (2017) Meta-analysis of test accuracy studies using imputation for partial reporting of multiple thresholds. Research Synthesis Methods. ISSN 1759-2887

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Abstract

INTRODUCTION: For tests reporting continuous results, primary studies usually provide test performance at multiple but often different thresholds. This creates missing data when performing a meta-analysis at each threshold. A standard meta-analysis (NI: No Imputation) ignores such missing data. A Single Imputation (SI) approach was recently proposed to recover missing threshold results. Here, we propose a new method (MIDC) that performs Multiple Imputation of the missing threshold results using Discrete Combinations. METHODS: The new MIDC method imputes missing threshold results by randomly selecting from the set of all possible discrete combinations which lie between the results for two known bounding thresholds. Imputed and observed results are then synthesised at each threshold. This is repeated multiple times, and the multiple pooled results at each threshold are combined using Rubin's rules to give final estimates. We compared the NI, SI and MIDC approaches via simulation. RESULTS: Both imputation methods outperform the NI method in simulations. There was generally little difference in the SI and MIDC methods, but the latter was noticeably better in terms of estimating the between-study variances and generally gave better coverage, due to slightly larger standard errors of pooled estimates. Given selective reporting of thresholds, the imputation methods also reduced bias in the summary ROC curve. Simulations demonstrate the imputation methods rely on an equal threshold spacing assumption. A real example is presented. CONCLUSIONS: The SI and, in particular, MIDC methods can be used to examine the impact of missing threshold results in meta-analysis of test accuracy studies.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Wiley at http://dx.doi.org/10.1002/jrsm.1276 - please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: diagnostic test accuracy, imputation, meta-analysis, multiple thresholds, publication bias
Subjects: R Medicine > R Medicine (General)
R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
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Depositing User: Symplectic
Date Deposited: 09 Nov 2017 15:54
Last Modified: 09 Nov 2017 15:59
URI: http://eprints.keele.ac.uk/id/eprint/4194

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