We should not pool diagnostic likelihood ratios in systematic reviews
Article first published online: 5 JUL 2007
Copyright © 2007 John Wiley & Sons, Ltd.
Statistics in Medicine
Volume 27, Issue 5, pages 687–697, 28 February 2008
How to Cite
Zwinderman, A. H. and Bossuyt, P. M. (2008), We should not pool diagnostic likelihood ratios in systematic reviews. Statist. Med., 27: 687–697. doi: 10.1002/sim.2992
- Issue published online: 9 JAN 2008
- Article first published online: 5 JUL 2007
- Manuscript Accepted: 25 MAY 2007
- Manuscript Received: 19 NOV 2006
- diagnostic likelihood ratio;
- bivariate random-effects model
Some authors plead for the explicit use of diagnostic likelihood ratios to describe the accuracy of diagnostic tests. Likelihood ratios are also preferentially used by some journals, and, naturally, are also used in meta-analysis. Although likelihood ratios vary between zero and infinity, meta-analysis is complicated by the fact that not every combination in ℜ+ is appropriate. The usual bivariate meta-analysis with a bivariate normal distribution can sometimes lead to positive probability mass at values that are not possible. We considered, therefore, three different statistical models that do not suffer from this drawback. All three approaches are so complicated that we advise to consider meta-analysis of sensitivity and specificity values instead of likelihood ratios. Copyright © 2007 John Wiley & Sons, Ltd.