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Biostatistics Group Seminar Series Research Institute for Primary Care and Health Sciences Keele University Title: Meta-analysis of diagnostic test accuracy across the full range of possible cut-offs. Speaker: Dr Hayley Jones, Bristol Medical School, University of Bristol. Date: Thursday 14th March 13:00-14:00 Venue: Dinwoodie Lecture Theatre, David Weatherall Building https://www.keele.ac.uk/connect/howtofindus/maps/keele-campus-guide-colour.pdf Abstract: The optimum threshold or cut-off at which to operate a diagnostic test is usually a key question for clinical practice. Standard methods for meta-analysis of test accuracy don’t facilitate answering this question, since they (i) don’t provide summary estimates of accuracy across the full range of thresholds, and (ii) can only synthesise a single pair of sensitivity and specificity from each study, despite studies often reporting data at more than one threshold. Several models have recently been proposed for a unified meta-analysis of all available data, via assumptions about the underlying distributional form of test results. I will describe a multinomial random effects model, fitted in WinBUGS, which synthesises test accuracy data across studies reporting at different and varying numbers of cut-offs. The model allows for a flexible range of underlying distributions of test results, through estimation of a Box-Cox transformation parameter. I will present examples including meta-analysis of the accuracy of B-type natriuretic peptide in the diagnosis of acute heart failure. In a recent collaboration with researchers at McGill University and with Gerta Rücker (University of Freiburg), we compared results from three alternative models fitted to data from 45 studies reporting on accuracy of PHQ-9 in diagnosing major depression. Each model was fitted to two alternative versions of the data: (i) that available from the study publications, (ii) the full individual participant data (IPD). I will present results from this study, in particular showing that our model fitted to the ‘published’ dataset well approximated the IPD. Dr Ivonne Solis-Trapala Deputy Lead, NIHR Research Design Service, West Midlands (Keele Hub) Senior Lecturer in Medical Statistics Research Institute for Primary Care and Health Sciences and Keele Clinical Trials Unit Faculty of Medicine and Health Sciences Keele University Staffordshire, ST5 5BG Room DJW1.51, e-mail: [log in to unmask] You may leave the list at any time by sending the command SIGNOFF allstat to [log in to unmask], leaving the subject line blank.