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Endocrine

, Volume 57, Issue 1, pp 18–34 | Cite as

Systematic reviews of diagnostic tests in endocrinology: an audit of methods, reporting, and performance

  • Gabriela Spencer-Bonilla
  • Naykky Singh Ospina
  • Rene Rodriguez-Gutierrez
  • Juan P. Brito
  • Nicole Iñiguez-Ariza
  • Shrikant Tamhane
  • Patricia J. Erwin
  • M. Hassan Murad
  • Victor M. MontoriEmail author
Meta-Analysis

Abstract

Background

Systematic reviews provide clinicians and policymakers estimates of diagnostic test accuracy and their usefulness in clinical practice. We identified all available systematic reviews of diagnosis in endocrinology, summarized the diagnostic accuracy of the tests included, and assessed the credibility and clinical usefulness of the methods and reporting.

Methods

We searched Ovid MEDLINE, EMBASE, and Cochrane CENTRAL from inception to December 2015 for systematic reviews and meta-analyses reporting accuracy measures of diagnostic tests in endocrinology. Experienced reviewers independently screened for eligible studies and collected data. We summarized the results, methods, and reporting of the reviews. We performed subgroup analyses to categorize diagnostic tests as most useful based on their accuracy.

Results

We identified 84 systematic reviews; half of the tests included were classified as helpful when positive, one-fourth as helpful when negative. Most authors adequately reported how studies were identified and selected and how their trustworthiness (risk of bias) was judged. Only one in three reviews, however, reported an overall judgment about trustworthiness and one in five reported using adequate meta-analytic methods. One in four reported contacting authors for further information and about half included only patients with diagnostic uncertainty.

Conclusion

Up to half of the diagnostic endocrine tests in which the likelihood ratio was calculated or provided are likely to be helpful in practice when positive as are one-quarter when negative. Most diagnostic systematic reviews in endocrine lack methodological rigor, protection against bias, and offer limited credibility. Substantial efforts, therefore, seem necessary to improve the quality of diagnostic systematic reviews in endocrinology.

Keywords

Diagnostic accuracy Diagnostic systematic review Systematic review methodology 

Notes

Acknowledgements

G.S.B. was supported by CTSA Grant Number TL1TR000137 from the National Center for Advancing Translational Science (NCATS) and Grant Number 3R01HL131535-01S1 from the National Heart Lung and Blood Institute (NHLBI). V.M.M. was partially supported by Grant Number UL1TR000135 from the NCATS, a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the author and do not necessarily represent the official view of the NIH.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

12020_2017_1298_MOESM1_ESM.docx (63 kb)
Supplementary Information

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Gabriela Spencer-Bonilla
    • 1
    • 2
  • Naykky Singh Ospina
    • 1
    • 3
  • Rene Rodriguez-Gutierrez
    • 1
    • 4
  • Juan P. Brito
    • 1
    • 5
  • Nicole Iñiguez-Ariza
    • 5
  • Shrikant Tamhane
    • 1
    • 5
  • Patricia J. Erwin
    • 6
  • M. Hassan Murad
    • 1
    • 7
  • Victor M. Montori
    • 1
    • 5
    Email author
  1. 1.Knowledge and Evaluation Research UnitMayo ClinicRochesterUSA
  2. 2.School of MedicineUniversity of Puerto Rico Medical Sciences CampusSan JuanUSA
  3. 3.Division of Endocrinology, Diabetes and Metabolism, Department of MedicineUniversity of FloridaGainesvilleUSA
  4. 4.Division of Endocrinology, Department of Internal MedicineUniversity Hospital “Dr. Jose E. Gonzalez”, Autonomous University of Nuevo LeonMonterreyUSA
  5. 5.Division of Endocrinology, Diabetes, Metabolism, and NutritionMayo ClinicRochesterUSA
  6. 6.Mayo Medical LibraryMayo ClinicRochesterUSA
  7. 7.Division of Preventive, Occupational, and Aerospace MedicineMayo ClinicRochesterUSA

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