Browsing by Author "Bossuyt, Patrick M. M."

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    Circulating antigen tests and urine reagent strips for diagnosis of active schistosomiasis in endemic areas
    (Cochrane, 2015-03-11) Ochodo, Eleanor Atieno; Gopalakrishna, Gowri; Spek, Bea; Reitsma, Johannes B.; Van Lieshout, Lisette; Polman, Katja; Lamberton, Poppy; Bossuyt, Patrick M. M.; Leeflang, Mariska M. G.
    Background : Point-of-care (POC) tests for diagnosing schistosomiasis include tests based on circulating antigen detection and urine reagent strip tests. If they had sufficient diagnostic accuracy they could replace conventional microscopy as they provide a quicker answer and are easier to use. Objectives : To summarise the diagnostic accuracy of: a) urine reagent strip tests in detecting active Schistosoma haematobium infection, with microscopy as the reference standard; and b) circulating antigen tests for detecting active Schistosoma infection in geographical regions endemic for Schistosoma mansoni or S. haematobium or both, with microscopy as the reference standard. Search methods : We searched the electronic databases MEDLINE, EMBASE, BIOSIS,MEDION, and Health Technology Assessment (HTA) without language restriction up to 30 June 2014. Selection criteria : We included studies that used microscopy as the reference standard: for S. haematobium, microscopy of urine prepared by filtration, centrifugation, or sedimentation methods; and for S. mansoni, microscopy of stool by Kato-Katz thick smear. We included studies on participants residing in endemic areas only.
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    Small-study effects and time trends in diagnostic test accuracy meta-analyses : a meta-epidemiological study
    (BioMed Central, 2015-05-09) Van Enst, Wynanda Annefloor; Naaktgeboren, Christiana A.; Ochodo, Eleanor A.; De Groot, Joris A. H.; Leeflang, Mariska M.; Reitsma, Johannes B.; Scholten, Rob J. P. M.; Moons, Karel G. M.; Zwinderman, Aeilko H.; Bossuyt, Patrick M. M.; Hooft, Lotty
    Background: Small-study effects and time trends have been identified in meta-analyses of randomized trials. We evaluated whether these effects are also present in meta-analyses of diagnostic test accuracy studies. Methods: A systematic search identified test accuracy meta-analyses published between May and September 2012. In each meta-analysis, the strength of the associations between estimated accuracy of the test (diagnostic odds ratio (DOR), sensitivity, and specificity) and sample size and between accuracy estimates and time since first publication were evaluated using meta-regression models. The regression coefficients over all meta-analyses were summarized using random effects meta-analysis. Results: Forty-six meta-analyses and their corresponding primary studies (N = 859) were included. There was a non-significant relative change in the DOR of 1.01 per 100 additional participants (95% CI 1.00 to 1.03; P = 0.07). In the subgroup of imaging studies, there was a relative increase in sensitivity of 1.13 per 100 additional diseased subjects (95% CI 1.05 to 1.22; P = 0.002). The relative change in DOR with time since first publication was 0.94 per 5 years (95% CI 0.80 to 1.10; P = 0.42). Sensitivity was lower in studies published later (relative change 0.89, 95% CI 0.80 to 0.99; P = 0.04). Conclusions: Small-study effects and time trends do not seem to be as pronounced in meta-analyses of test accuracy studies as they are in meta-analyses of randomized trials. Small-study effects seem to be reversed in imaging, where larger studies tend to report higher sensitivity.