Systematic reviews and meta-analyses of test accuracy: developing methods that meet practitioners’ needs

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http://eprints.org/relation/isVersionOf http://etheses.bham.ac.uk/id/document/22836 http://eprints.org/relation/isVolatileVersionOf http://etheses.bham.ac.uk/id/document/22836 http://eprints.org/relation/isIndexCodesVersionOf http://etheses.bham.ac.uk/id/document/22836 archive 4031 disk0/00/00/34/27 2012-12-03 17:22:15 2019-01-23 09:56:15 2012-12-03 17:22:15 thesis show 0 Davenport Clare Frances Hyde Christopher MacArthur Christine ftp://ubira.bham.ac.uk/eTheses/3427_Davenport/ University of Birmingham Systematic reviews and meta-analyses of test accuracy: developing methods that meet practitioners’ needs unpub RA0421 RC 10col_mede Testing can be a substantial driver of health care costs. Increase in test use over recent decades has occurred despite disappointing results from test accuracy evaluations. Poor quality and reporting of primary test accuracy studies and difficulties with understanding and application of test accuracy information are purported to be important contributors to this observed evidence ‘gap’. The objectives of this thesis were to: * Systematically review evidence concerning the understanding and application of test accuracy metrics. * Undertake primary research building on the review of understanding and application. * Assess whether the contribution of test accuracy reviews to the test accuracy evidence base is compromised by deficiencies in their contextual fit, or of included primary studies. Existing research concerned with understanding and application of test accuracy information is not driven by the needs of decision makers. Contrary to the prevailing view in the literature, findings of original research from this thesis demonstrate that probability revision is not a feature of diagnostic decision making. Choice of test accuracy metric however was shown to have a profound influence on diagnostic decision making. Deficiencies in question formulation and contextualisation of test accuracy reviews are undermining their contribution to the test accuracy evidence base. 2012-12 2012-04 graduation eng author unchecked This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. public 503 University of Birmingham School of Health and Population Studies, Department of Public Health, Epidemiology and Biostatictics d_ph na 2012-12 graduation