摘要
目的:调查2014年1月至11月国内期刊发表的诊断试验准确性(diagnostic test accuracy,DTA)Meta分析中简单合并模型与双变量模型的使用现状,分析两模型间结果的差异性,并探讨这种差异性与研究间异质性大小的关系。方法:对《中国生物医学文献数据库》2014年1月至11月收录的文献进行检索,纳入DTA Meta分析,描述模型使用的相关信息,提取四格表数据,使用简单合并模型和双变量模型进行重分析,用非参数检验比较模型结果间差值,定性探究灵敏度、特异度异质性大小与结果间差值的关系。结果:共纳入55篇文章,包括58个DTA Meta分析,其中25个Meta分析用于重分析。简单合并模型与双变量模型的使用比例分别为90.9%(50/55)、1.8%(1/55),使用其他合并模型或未合并灵敏度和特异度的文献比例为7.3%(4/55)。在50篇使用简单合并模型合并灵敏度和特异度的文章中,41篇(82.0%)存在误用Meta-disc软件的可能。两种模型所得灵敏度、特异度差值中位数均为0.011(P<0.001,P=0.031),灵敏度和特异度差值随着I2增大变异程度逐渐增大,I2大于75%时变异程度更为明显。结论:国内期刊发表的DTA Meta分析对灵敏度和特异度进行合并时大多使用简单合并模型,且Meta-disc软件常被误认为可对灵敏度和特异度进行随机效应合并;简单合并模型可能低估真实值,尤其研究间异质性大时其合并值与双变量模型间差异更为明显,研究者应当提高正确认识和选用合并方法的能力。
Objective：To investigate the use of simple pooling and bivariate model in meta-analyses of diagnostic test accuracy （DTA） published in Chinese journals （January to November, 2014）, compare the differences of results from these two models, and explore the impact of between-study variability of sensitivity and specificity on the differences. Methods：DTA meta-analyses were searched through Chi-nese Biomedical Literature Database （January to November, 2014）. Details in models and data for four-fold table were extracted. Descriptive analysis was conducted to investigate the prevalence of the use of simple pooling method and bivariate model in the included literature. Data were re-analyzed with the two models respectively. Differences in the results were examined by Wilcoxon signed rank test. How the re-sults differences were affected by between-study variability of sensitivity and specificity, expressed by I2 , was explored. Results：The 55 systematic reviews, containing 58 DTA meta-analyses, were included and 25 DTA meta-analyses were eligible for re-analysis. Simple pooling was used in 50 （90. 9%） systematic reviews and bivariate model in 1 （1. 8%）. The remaining 4 （7. 3%） articles used other models pooling sensitivity and specificity or pooled neither of them. Of the reviews simply pooling sensitivity and specificity, 41（82. 0%） were at the risk of wrongly using Meta-disc software. The differences in medians of sensitivity and specificity between two models were both 0. 011（ P＆lt;0. 001, P=0. 031 respectively）. Greater differences could be found as I2 of sensitivity or specificity became larger, especially when I2 ＆gt;75%. Conclusion：Most DTA meta-analyses published in Chinese journals（January to November, 2014） combine the sensitivity and specificity by simple pooling. Meta-disc software can pool the sensitivity and specificity only through fixed-effect model, but a high proportion of authors think it can implement＆amp;nbsp;random-effect model. Simple pooling tends
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2015年第3期483-488,共6页
Journal of Peking University:Health Sciences
基金
高等学校博士学科点专项科研基金(20120001110015)资助~~
