Survey of the methods and reporting practices in published meta‐analyses of test performance: 1987 to 2009

We performed a survey of meta-analyses of test performance to describe the evolution in their methods and reporting. Studies were identified through MEDLINE (1966–2009), reference lists, and relevant reviews. We extracted information on clinical topics, literature review methods, quality assessment, and statistical analyses. We reviewed 760 publications reporting meta-analyses of test performance, published between 1987 and 2009. Eligible reviews included a median of 18 primary studies that were used in quantitative analyses. Most common clinical areas were cardiovascular disease (21%) and oncology (25%); most common test categories were imaging (44%) and biomarker tests (28%). Assessment of verification and spectrum bias, blinding, prospective study design, and consecutive patient recruitment became more common over time (p < 0.001 comparing reviews published through 2004 vs 2005 onwards). These changes coincided with the increasing use of checklists to guide assessment of methodological quality. Heterogeneity tests were used in 58% of meta-analyses; subgroup or regression analyses were used in 57%. Random effects models were employed in 57% of meta-analyses (38% through 2004 vs 72% 2004–onwards; p < 0.001). Use of bivariate models of sensitivity and specificity increased in recent years (21% in 2008–2009 vs 7% in earlier years; p < 0.001). Methods employed in meta-analyses of test performance have improved with the introduction of quality assessment checklists and the development of more sophisticated statistical methods. Copyright © 2013 John Wiley & Sons, Ltd.