An one-factor copula mixed model for joint meta-analysis of multiple diagnostic tests

–The area under the curve (AUC) of summary receiver operating characteristic (SROC) curve is a primary statistical outcome for meta-analysis of diagnostic test accuracy studies (DTA). However, its confidence interval has not been reported in most of DTA meta-analyses, because no certain methods and statistical packages have been provided. In this article, we provide a bootstrap algorithm for computing the confidence interval of the AUC. Also, using the bootstrap framework, we can conduct a bootstrap test for assessing significance of the difference of AUCs for two diagnostic tests. In addition, we provide an influence diagnostic method based on the AUC by leave-one-study-out analyses. We present illustrative examples using two DTA met-analyses for diagnostic tests of cervical cancer and asthma. We also developed an easy-to-handle R package dmetatools for these computations. The various quantitative evidence provided by these methods certainly supports the interpretations and precise ev …

For a particular disease, there may be two diagnostic tests developed, where each of the tests is subject to several studies. A quadrivariate generalised linear mixed model (GLMM) has been recently proposed to joint meta-analyse and compare two diagnostic tests. We propose a D-vine copula mixed model for joint meta-analysis and comparison of two diagnostic tests. Our general model includes the quadrivariate GLMM as a special case and can also operate on the original scale of sensitivities and specificities. The method allows the direct calculation of sensitivity and specificity for each test, as well as the parameters of the summary receiver operator characteristic (SROC) curve, along with a comparison between the SROCs of each test. Our methodology is demonstrated with an extensive simulation study and illustrated by meta-analysing two examples where two tests for the diagnosis of a particular disease are compared. Our study suggests that there can be an improvement on GLMM in fit to …

Objectives: This study provides an effective model selection method based on the empirical likelihood approach for constructing summary receiver operating characteristic (sROC) curves from meta-analyses of diagnostic studies. Methods: We considered models from combinations of family indices and specific pairs of transformations, which cover several widely used methods for bivariate summary of sensitivity and specificity. Then a final model was selected using the proposed empirical likelihood method. Simulation scenarios were conducted based on different number of studies and different population distributions for the disease and non-disease cases. The performance of our proposal and other model selection criteria was also compared. Results: Although parametric likelihood-based methods are often applied in practice due to its asymptotic property, they fail to consistently choose appropriate models for summary under the limited number of studies. For these situations, our proposed method …

Diagnostic test accuracy studies typically report the number of true positives, false positives, true negatives and false negatives. There usually exists a negative association between the number of true positives and true negatives, because studies that adopt less stringent criterion for declaring a test positive invoke higher sensitivities and lower specificities. A generalized linear mixed model (GLMM) is currently recommended to synthesize diagnostic test accuracy studies. We propose a copula mixed model for bivariate meta-analysis of diagnostic test accuracy studies. Our general model includes the GLMM as a special case and can also operate on the original scale of sensitivity and specificity. Summary receiver operating characteristic curves are deduced for the proposed model through quantile regression techniques and different characterizations of the bivariate random effects distribution. Our general methodology is demonstrated with an extensive simulation study and illustrated …

This paper introduces the \proglang{R} package \pkg{meta4diag} for implementing Bayesian bivariate meta-analyses of diagnostic test studies. Our package \pkg{meta4diag} is a purpose-built front end of the \proglang{R} package \pkg{INLA}. While \pkg{INLA} offers full Bayesian inference for the large set of latent Gaussian models using integrated nested Laplace approximations, \pkg{meta4diag} extracts the features needed for bivariate meta-analysis and presents them in an intuitive way. It allows the user a straightforward model-specification and offers user-specific prior distributions. Further, the newly proposed penalised complexity prior framework is supported, which builds on prior intuitions about the behaviours of the variance and correlation parameters. Accurate posterior marginal distributions for sensitivity and specificity as well as all hyperparameters, and covariates are directly obtained without Markov chain Monte Carlo sampling. Further, univariate estimates of interest, s …