High and unclear risk of bias assessments are predominant in diagnostic accuracy studies included in Cochrane reviews

Journal of Clinical Epidemiology
Nicola Di GirolamoReint Meursinge Reynders

Abstract

The validity of outcomes of systematic reviews is highly dependent on the extent of bias in the included primary studies. This study reports the risk of bias (ROB) of primary studies included in systematic reviews of diagnostic accuracy. All systematic reviews of diagnostic accuracy studies published in the Cochrane database in 2015 and 2016 that used the Quality Assessment of Diagnostic Accuracy Studies-2 ROB tool and reported results with the ROB figure were eligible. The primary outcome was the prevalence of "high" or "unclear" ROB scores for the four Quality Assessment of Diagnostic Accuracy Studies-2 domains: "patient selection," "index test," "reference standard," and "flow and timing". Of 46 eligible reviews, 35 fulfilled the inclusion criteria. A total of 1045 primary studies with 4133 bias assessments were identified. Of those, 56% (2319/4133) were assessed to be at "high" or "unclear" ROB and 44% (1814/4133) at low ROB. For all domains except "flow and timing," most outcomes were scored as "high" or "unclear" ROB. A total of 47 (47/1045; 4.5%, 3.4 to 5.9%) primary studies were scored at low ROB for all domains. Older article age was significantly associated with likelihood of "high" or "unclear" ROB (odds ratio: 1.02;...Continue Reading

Citations

Apr 18, 2018·Muscle & Nerve·Raghav Govindarajan, Pushpa Narayanaswami
Feb 9, 2019·JMIR Research Protocols·Edward MeinertDavid Brindley
Mar 2, 2019·Hernia : the Journal of Hernias and Abdominal Wall Surgery·S G JørgensenJ Rosenberg
Jan 29, 2019·Expert Review of Vaccines·Sandrine I SamsonRosalind Hollingsworth
Jun 28, 2019·BMC Pulmonary Medicine·Trisha M ParekhAndrea Cherrington
Sep 30, 2019·British Journal of Sports Medicine·Andre NiemeijerCarsten B Juhl
Mar 16, 2021·Intensive & Critical Care Nursing : the Official Journal of the British Association of Critical Care Nurses·Dimitrios Lathyris, Anna-Bettina Haidich

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