Meta-epidemiologic study showed frequent time trends in summary estimates from meta-analyses of diagnostic accuracy studies

Abstract

Objectives: To evaluate changes over time in summary estimates from meta-analyses of diagnostic accuracy studies.

Study design and setting: We included 48 meta-analyses from 35 MEDLINE-indexed systematic reviews published between September 2011 and January 2012 (743 diagnostic accuracy studies; 344,015 participants). Within each meta-analysis, we ranked studies by publication date. We applied random-effects cumulative meta-analysis to follow how summary estimates of sensitivity and specificity evolved over time. Time trends were assessed by fitting a weighted linear regression model of the summary accuracy estimate against rank of publication.

Results: The median of the 48 slopes was -0.02 (-0.08 to 0.03) for sensitivity and -0.01 (-0.03 to 0.03) for specificity. Twelve of 96 (12.5%) time trends in sensitivity or specificity were statistically significant. We found a significant time trend in at least one accuracy measure for 11 of the 48 (23%) meta-analyses.

Conclusion: Time trends in summary estimates are relatively frequent in meta-analyses of diagnostic accuracy studies. Results from early meta-analyses of diagnostic accuracy studies should be considered with caution.

Keywords: Cumulative meta-analysis; Diagnostic accuracy; Meta-analysis; Sensitivity and specificity; Systematic reviews; Time trends.