Background
Methods
Gold standard | |||
---|---|---|---|
Index test |
+
|
−
| Total |
n
i11
|
n
i10
|
n
i1+
| |
+ | (1−ω
i m1)π
i
S e
i
| (1−ω
i m0)(1−π
i
)(1−S p
i
) | (1−ω
i m1)π
i
S e
i
+(1−ω
i m0)(1−π
i
)(1−S p
i
) |
n
i01
|
n
i00
|
n
i0+
| |
− | (1−ω
i m1)π
i
(1−S e
i
) | (1−ω
i m0)(1−π
i
)S p
i
| (1−ω
i m1)π
i
(1−S e
i
)+(1−ω
i m0)(1−π
i
)S p
i
|
n
i m1
|
n
i m0
|
n
i m+
| |
Missing |
ω
i m1
π
i
|
ω
i m0(1−π
i
) |
ω
i m1
π
i
+ω
i m0(1−π
i
) |
n
i+1
|
n
i+0
|
n
i++
| |
Total |
π
i
| 1−π
i
| 1 |
Results
Simulations
Simulation scenarios
Simulation results
Model | TGLMM | Model 1 | Model2 | Model3 | Intent-to-diagnose | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Estimate | Bias% | meanSE | CP | Bias% | meanSE | CP | Bias% | meanSE | CP | Bias% | meanSE | CP | Bias% | meanSE | CP |
ω
m1
=ω
m0
=0.1
| |||||||||||||||
Se | −0.3 | 0.041 | 0.94 | −0.3 | 0.041 | 0.94 | 4.6 | 0.036 | 0.81 | −12.6 | 0.037 | 0.33 | −12.6 | 0.036 | 0.33 |
Sp | −0.1 | 0.017 | 0.93 | −0.1 | 0.017 | 0.93 | −11.9 | 0.018 | 0 | 1.1 | 0.015 | 0.84 | −11.9 | 0.017 | 0 |
Prev | 0.8 | 0.034 | 0.93 | 0.8 | 0.034 | 0.93 | 0.8 | 0.034 | 0.93 | 0.8 | 0.034 | 0.93 | 0.8 | 0.034 | 0.93 |
PPV | −0.1 | 0.046 | 0.94 | −0.3 | 0.046 | 0.94 | −22.6 | 0.047 | 0.08 | −0.9 | 0.046 | 0.94 | −29 | 0.049 | 0.01 |
NPV | −0.1 | 0.018 | 0.93 | −0.1 | 0.018 | 0.93 | −0.2 | 0.018 | 0.93 | −2.9 | 0.020 | 0.81 | −4.6 | 0.022 | 0.59 |
LR+ | 1.6 | 1.188 | 0.92 | 1.6 | 1.189 | 0.93 | −49.2 | 0.307 | 0 | −0.5 | 1.160 | 0.92 | −57.6 | 0.271 | 0 |
LR − | 0.9 | 0.044 | 0.94 | 0.9 | 0.044 | 0.94 | 1.5 | 0.044 | 0.94 | 27.9 | 0.039 | 0.33 | 46.8 | 0.045 | 0.04 |
ω
m1
=0.1,ω
m0
=0.2
| |||||||||||||||
Se | −0.1 | 0.041 | 0.94 | −0.1 | 0.041 | 0.94 | 4.7 | 0.036 | 0.80 | −12.3 | 0.036 | 0.34 | −12.3 0.036 | 0.34 | |
Sp | −0.1 | 0.017 | 0.94 | −0.1 | 0.017 | 0.94 | −22.3 | 0.017 | 0 | 2.2 | 0.014 | 0.62 | −22.3 | 0.017 | 0 |
Prev | 0.4 | 0.034 | 0.93 | 9.6 | 0.036 | 0.90 | 0.4 | 0.034 | 0.93 | 0.4 | 0.034 | 0.93 | 0.4 | 0.034 | 0.93 |
PPV | −0.3 | 0.046 | 0.93 | 3.1 | 0.044 | 0.88 | −36 | 0.047 | 0 | 2.7 | 0.044 | 0.89 | −42.1 | 0.047 | 0 |
NPV | −0.1 | 0.018 | 0.94 | −1.3 | 0.020 | 0.93 | −1.4 | 0.020 | 0.92 | −2.7 | 0.020 | 0.83 | −6.3 | 0.024 | 0.36 |
LR+ | 1.4 | 1.195 | 0.94 | 1.4 | 1.194 | 0.94 | −65.1 | 0.159 | 0 | 12.3 | 1.312 | 0.95 | −70.8 | 0.147 | 0 |
LR − | 0.6 | 0.044 | 0.93 | 0.6 | 0.044 | 0.93 | 14.7 | 0.050 | 0.85 | 26.1 | 0.038 | 0.39 | 66.1 | 0.051 | 0 |
ω
m1
=0.2,ω
m0
=0.1
| |||||||||||||||
Se | -0.1 | 0.023 | 0.93 | -0.1 | 0.023 | 0.93 | 8.7 | 0.018 | 0.12 | -21 | 0.020 | 0 | -21 | 0.019 | 0 |
Sp | 0 | 0.009 | 0.93 | 0 | 0.009 | 0.93 | -10.6 | 0.009 | 0 | 1.1 | 0.008 | 0.74 | -10.6 | 0.009 | 0 |
Prev | 0 | 0.018 | 0.93 | -8.4 | 0.017 | 0.72 | 0 | 0.017 | 0.91 | 0 | 0.017 | 0.91 | 0 | 0.0168 | 0.89 |
PPV | -0.1 | 0.025 | 0.93 | -3.7 | 0.027 | 0.83 | -19.1 | 0.025 | 0 | -4 | 0.026 | 0.8 | -30.6 | 0.025 | 0 |
NPV | 0 | 0.010 | 0.92 | 1.1 | 0.009 | 0.76 | 1.1 | 0.009 | 0.74 | -4.6 | 0.011 | 0.05 | -6.2 | 0.012 | 0 |
LR+ | 0.3 | 0.655 | 0.93 | 0.3 | 0.653 | 0.93 | -44.1 | 0.196 | 0 | -11.7 | 0.570 | 0.62 | -59.3 | 0.154 | 0 |
LR − | 0.3 | 0.025 | 0.93 | 0.3 | 0.025 | 0.93 | -10.8 | 0.022 | 0.62 | 47.4 | 0.021 | 0 | 66.7 | 0.024 | 0 |
Re-evaluation of the meta-analysis of coronary CT angiography studies
Method | Sensitivity | Specificity | Prevalence | PPV | ||||
---|---|---|---|---|---|---|---|---|
TGLMM | 98.0 (96.7,99.3) | 87.5 (82.7,92.3) | 47.8 (37.9,57.7) | 87.8 (83.3,92.3) | ||||
Model 1 | 98.0 (96.7,99.3) | 87.4 (82.5, 92.3) | 49.3 (38.9,59.7) | 88.4 (84,92.7) | ||||
Model 2 | 98.1 (96.9,99.3) | 75.9 (69.3,82.5) | 47.8 (37.9,57.8) | 78.9 (71.9,85.9) | ||||
Model 3 | 91.7 (88.1,95.4) | 89 (85.4,92.7) | 47.8 (37.9,57.7) | 88.4 (84.1,92.7) | ||||
Intent-to-diagnose | 91.7 (88.1,95.3) | 76.2 (69.7,82.6) | 47.9 (37.9,57.9) | 78 (70.2,85.7) | ||||
Method
|
NPV
|
LR+
|
LR −
|
AUC
| ||||
TGLMM | 97.9 (96.4,99.5) | 7.8 (4.8,10.9) | 0.02 (0.01,0.04) | 0.99 (0.96,1) | ||||
Model 1 | 97.8 (96.1,99.4) | 7.8 (4.8,10.9) | 0.02 (0.01,0.04) | 0.99 (0.96,1) | ||||
Model 2 | 97.8 (96.2, 99.4) | 4.1 (2.9,5.2) | 0.02 (0.01,0.04) | 0.98 (0.97,1) | ||||
Model 3 | 92.1 (88.4,95.8) | 8.4 (5.5,11.3) | 0.09 (0.05,0.14) | 0.96 (0.93,0.99) | ||||
Intent-to-diagnose | 90.9 (86.4,95.5) | 3.8 (2.7,5.0) | 0.11 (0.06,0.16) | 0.93 (0.89,0.96) |
Discussions
Conclusions
Claims
Appendix: SAS code of the extended TGLMM approach: meta-analysis of coronary CT angiography studies
![https://static-content.springer.com/image/art%3A10.1186%2F1471-2288-14-128/MediaObjects/12874_2014_Article_1143_Equg_HTML.gif](https://static-content.springer.com/image/art%3A10.1186%2F1471-2288-14-128/MediaObjects/12874_2014_Article_1143_Equg_HTML.gif)