The unfamiliarity of DTA methods and accuracy metrics makes it difficult to convey results to a wide audience. Results can be misinterpreted.
"Systematic reviews of diagnostic test accuracy provide a summary of test performance based on all available evidence, evaluate the quality of published studies, and account for variation in findings between studies." JBI Reviewers Handbook
Diagnostic Test Accuracy Reviews are best designed for:
Assessing the true evidence from diagnostic test accuracy (DTA) studies
Timeframe: 12+ Months
Question: Participants, index test or tests (to evaluate may be old or new), target condition(s) (what you are trying to diagnose), reference standard(s) or reference test (the existing diagnostic test) for verification of index test results (there may be more than one reference standard)
Most DTA review questions are comparative-to replace an existing test, to be used in addition to another test or to decide whether another test should be undertaken (triage)
Sources and searches: Comprehensive & rigorous, includes a combination of database, grey literature and hand searching to locate published and unpublished literature
See our Systematic Review Search Service for help conducting the search!
Selection: Based on inclusion/exclusion criteria
Appraisal: Critical and rigorous assessment of bias and appraisal using STARD and/or QUADAS-2 or JBI reviewers critical appraisal checklist
Synthesis: Qualitative with Summary of Findings table (SOF) and Quantitative (Meta-Analysis)- varies slightly from a traditional systematic review
*"The Cochrane DTA review structure has three fixed subheadings under the discussion section to guide the interpretation of the results: ‘Summary of main results’ ‘Qualifying DTA evidence’, and ‘Applicability of findings to the review question’. The authors’ conclusions section is divided into ‘Implications for practice’ and ‘Implications for research’."
This link will open a PDF document.
PRISMA-DTA extension statement: http://www.equator-network.org/reporting-guidelines/prisma-dta/
DTA Cochrane Reviews Handbook
JBI Reviewers' Manual: Diagnostic Test Accuracy Systematic Reviews (2020)
Cohen J, Korevaar D, Altman D, Bruns D, Gatsonis C, Hooft L, Irwig L, Levine D, Reitsma J, de Vet H, Bossuyt P. STARD 2015 guidelines for reporting diagnostic accuracy studies: explanation and elaboration. BMJ Open. 2016;6:e012799.
Whiting PF, Rutjes AW, Westwood ME, Mallett S, QUADAS-2 Steering Group. A systematic review classifies sources of bias and variation in diagnostic test accuracy studies. J Clin Epidemiol. 2013 Oct; 66(10):1093-104.