In the recent book of diagnostic metaanalysis, doebler et al. I have used first metadisc, but only for descriptive purposes, as it is clear that univariate approaches such as those provided by this package are biased eg takwoingi et al. Metaprop is a statistical program implemented to perform metaanalyses of proportions in stata. An updated collection from the stata journal, second edition, which brought together all the stata journal articles about the. The bivariate model was used to calculate the pooled diagnostic parameters and summary receiver operator characteristic sroc curve in this metaanalysis, thereby estimating the whole predictive performance. Metaanalysis can be performed in various general statistical and numerical analysis environments e. We present a stata package, metandi, to facilitate the fitting of such models. Likelihoodbased estimation is by adaptive gaussian quadrature using xtmelogit stata release 10. Metaanalysis of diagnostic test accuracy studies with stata. T2 software for metaanalysis of binary, continuous and diagnostic data. Review article diagnostic value of circulating methylated.
Diagnostic significance of micrornas as novel biomarkers. Stata module to perform metaanalysis of diagnostic accuracy, statistical software components s456932, boston college department of economics. In this study we simulated meta analyses under a number of scenarios and evaluated hierarchical models for meta analysis of diagnostic accuracy studies. The online pubmed, medline, embase, cnki and wanfang literature. Stata programs of interest either to a wide spectrum of users e. This is not an introduction to the use of stata software. Metaanalysis of diagnostic accuracy with mada philipp doebler wwu m unster heinz holling wwu m unster abstract the rpackage mada is a tool for the metaanalysis of diagnostic accuracy. All prospective studies of the diagnostic accuracy of ultrasound versus radiography.
Stata 9 is a statistical package widely used in the fields of biomedicine. The metadisc software was used to implement the metaanalysis, and sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio with their 95% confidence intervals cis were used as the effect size. A total of 6,079 subjects included 1,890 colorectal cancer patients in 20 studies were included in this metaanalysis. We pooled sensitivity and specificity with a bivariate diagnostic metaanalysis metandi. Recommended softwarepackages for metaanalysis of diagnostic. Then, i have found the following bivariate methods, and. I am conducting a meta analysis of diagnostic test accuracy studies focusing on myocardial perfusion imaging. We searched medline, web of science and the cochrane library from inception to september 2015. Appropriate and accessible statistical software is needed to produce the summary statistic of interest. The present comparison study included 4,537 participants and 1,277 cases of pancreatic cancer that were derived from studies with a broad range of characteristics.
Comprehensive metaanalysis is, in my view, the best metaanalysis software on the market and a must have for any metaanalyst. In contrast to univariate metaanalysis, diagnostic metaanalysis requires bivariate models. Meta analysis of diagnostic accuracy with mada philipp doebler wwu m unster heinz holling wwu m unster abstract the rpackage mada is a tool for the meta analysis of diagnostic accuracy. Nonprofit organization promoting dissemination of reliable health. Metaanalyses have become an essential tool in synthesizing evidence on clinical and epidemiological questions derived from a multitude of similar studies assessing the particular issue. Nov 10, 2014 this article presents a general overview of the program to serve as a starting point for users interested in performing metaanalysis of proportions in stata software. See stata s full list of official metaanalysis features stata users have also developed numerous excellent commands for performing metaanalyses. In this section you can download the metaeasy excel addin, described in the journal of statistical software click here for the paper. Many test accuracy studies are small,2 and even when studies are large, the number of cases may be small due to the low prevalence of the target condition. This method fits a twolevel model, with independent binomial. The software performs several metaanalysis and metaregression models. To perform a metaanalysis evaluating the diagnostic ability of fecal lactoferrin fl to distinguish inflammatory bowel disease ibd from irritable bowel syndrome ibs. Currently, there is a macro avaibale for sas and a package for stata.
In contrast to univariate meta analysis, diagnostic meta analysis requires bivariate models. Our findings indicate that simplifying hierarchical models is valid when there are few studies or sparse data. However, there is currently no dedicated and comprehensive software for metaanalysis of diagnostic data. Di erent statistical software environments, such as sas software sas institute inc. As a concern for meta analysis of diagnostic trials, publication bias was tested using the funnel plot and deeks test 18, which was conducted by a regression of diagnostic log odds ratio against. The summary estimates for circulating methylated sept9 dna in the diagnosis of. The purpose of the present study was to compare the diagnostic value of ca 199 with cea for pancreatic cancer. As these become available we will add them to this page. The bivariate metaanalysis model was used to estimate the pooled results of sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio with their corresponding 95%. Primary data synthesis is performed within the bivariate mixedeffects logistic regression modeling framework. Metaanalysis of diagnostic test accuracy presents many challenges.
Within a frequentist setting the sas proc mixed routine and proc nlmixed routine can be used to t. There are loads of packages in r associated with metaanalysis. Pcr assay with blood specimens from highrisk hematology patients. Will not cover any of the more advanced topics, such as multiple imputation of missing data or multilevel metaanalysis. Which is the best method for metaanalysis of diagnostic. Let me know in the comment section below what metaanalysis software you are using. In particular, requiring that users learn an entire language to run their analyses will prohibit general adaptation of a program. In practice, most metaanalyses are performed in general statistical packages or dedicated metaanalysis programs. In this article, we present metadisc, a windowsbased, userfriendly, freely available for academic use software that we have developed. The studies were obtained from electronic searches conducted in pubmed, embase, and cochrane library databases until december 2017. Diagnostic efficacy of long noncoding rna in lung cancer. The methodological quality of each study was assessed by the quality assessment of diagnostic accuracy studies quadas2. Among the existing metaanalysis software tools, revman 5. How you do your network metaanalysis in r will depend on the nature of your input data, number of competing diagnostic tests being compared in each study, whether or not you have any covariate information, whether or not you have study armlevel information only or studylevel information, etc.
Stata module for metaanalytical integration of diagnostic test accuracy studies, statistical software components s456880, boston college department of economics, revised 05 feb 2009. Performance of methods for metaanalysis of diagnostic. Before i used this software, i was convinced that specialized metaanalysis software was not necessary at all. Official metaanalysis commands are available in stata 16 stata 16 contains a suite of commands for performing metaanalysis. Performance of methods for metaanalysis of diagnostic test. I prefee stata for metaanalyses on diagnostic studies entering the true. In stata 10 metandi fits the model using the builtin command xtmelogit by. Which is the best method for metaanalysis of diagnostic test. I have used first meta disc, but only for descriptive purposes, as it is clear that univariate approaches such as those provided by this package are biased eg takwoingi et al. Comprehensive metaanalysis tutorial means basic youtube. Stata 16 contains a suite of commands for performing meta analysis. Dec 04, 2009 in order to attain widespread use, metaanalysis software must be easy to use. Therefore, we conducted this meta analysis to elucidate the diagnostic efficacy of lncrna in identification of lung cancer including small cell lung cancer. However, the diagnostic efficacy of lncrna in different studies is inconsistent.
Sensitivity, specificity, positive likelihood ratio plr, negative likelihood ratio nlr, and diagnostic odds ratio dor with their 95% confidence intervals cis were used as the measure of effect size. Ca 199 and carcinoembryonic antigen cea are widely used for the diagnosis of pancreatic cancer. Dec 12, 2011 comprehensive meta analysis tutorial means basic. Stata module to perform metaanalysis of diagnostic. The specifications for the scenarios were devised to replicate realistic situations encountered in metaanalysis of diagnostic accuracy studies. Then, i have found the following bivariate methods, and used several of them. While stata has no intrinsic support for metaanalysis, various experts have written macros for metaanalysis, which can be downloaded from the stata web site and incorporated into stata. Many different packages are available but not all of them are well developed.
Stata module for metaanalytical integration of diagnostic. The detection of long noncoding rna lncrna is a novel method for lung cancer diagnosis. Using revman and stata for metaanalyses wednesday, 22 january 8. Nlr, diagnostic odds ratio dor, and summary receiver operating characteristic sroc curve were pooled using stata 12. Meta analysis of studies of diagnostic tests a special case of multivariate meta analysis is the case of summarising studies of diagnostic tests. Even in the simplest case, when the data are summarized by a 2. The medline, embase, web of science, cochrane library and cnki databases were systematically searched for studies that used fl concentrations to distinguish between ibd and ibs. Even in the simplest case, when the data are summarized by a 2 x 2 table from each study, a statistically rigorous analysis requires hierarchical multilevel models that respect the binomial data structure, such as hierarchical logistic regression.
Unlike other dedicated metaanalysis packages, metaanalyst integrates the capabilities to perform metaanalyses of binary or continuous outcomes and diagnostic or prognostic tests, combining the functionality of software such as mix and metadisc. Study objective to determine the diagnostic accuracy of ultrasound for detecting distal forearm fractures. Results from analyses of diagnostic and prognostic test studies have. The diagnostic metaanalysis was conducted by the metadisc software version 1. We included all studies involving human subjects that assessed the. I am conducting a metaanalysis of diagnostic test accuracy studies focusing on myocardial perfusion imaging.
Development of an interactive webbased tool to conduct and. Diagnostic value of ca 199 and carcinoembryonic antigen. Features new in stata 16 disciplines stata mp which stata is right for me. Metaanalysis is increasingly used as a key source of evidence synthesis to inform clinical practice. Methods a detailed description of various statistical procedures to perform metaanalysis which can be performed with metan can be found elsewhere 10. The theory and statistical foundations of metaanalysis continually evolve, providing solutions to many new and challenging problems. It fits a twolevel mixed logistic regression model, with independent binomial distributions for the true positives and true negatives within each study, and a bivariate normal model for the logit transforms of. What are the needed data to extract in a diagnostic metaanalysis. See statas full list of official metaanalysis features stata users have also developed numerous excellent commands for performing metaanalyses.
Even in the simplest case, when the data are summarized by a 2 x 2 table from each study, a statistically rigorous analysis requi. Any statistical software with general mixed model can be employed for fitting the advanced metaanalysis models. To properly conduct dta ma in revman other programs such as stata. Recommended statistical methods for metaanalysis of diagnostic test. In this article, we present metadisc, a windowsbased, userfriendly, freely available for academic use software that we have developed, piloted, and. At that time, i used my own excel spreadsheets and spss to run metaanalysis. This gives rise to a bivariate, binary meta analysis with the withinstudy correlation assumed zero although the betweenstudy correlation is estimated. Recommended software packages for metaanalysis of diagnostic accuracy when performing a metaanalysis of diagnostic accuracy, authors usually need to use a statistical package. As of stata 16, stata has an official suite of metaanalysis commands. All the analyses of diagnostic accuracy were performed using stata 15. Methods for metaanalysis of diagnostic test accuracy studies.
Fecal lactoferrin in discriminating inflammatory bowel. Metaanalysis of diagnostic accuracy studies in mental health. Harbord rm, whiting p 2009 metaanalysis of diagnostic accuracy using hierarchical logistic regression. Dedicated metaanalysis programs such as mix, comprehensive metaanalysis, and metadisc are appealing due to their small learning curve. Therefore, we conducted this metaanalysis to elucidate the diagnostic efficacy of lncrna in identification of lung cancer including small cell lung cancer. Invasive aspergillosis is a difficulttodiagnose infection with a high mortality rate that affects highrisk groups such as patients with neutropenia and hematologic malignancies. Evaluation of polymerase chain reaction assays for direct. A recent overview compared the features of 6 graphical user interface packages dedicated to metaanalysis. I found the comprehensive metaanalysis software program to be extremely user friendly, providing instant computational data from the simplest to the most complex statistical problems, a versatile database to help organize and restructure large volumes of multifaceted data, and parallel visuals that help better understand your data. In this article, we present metadisc, a windowsbased, userfriendly, freely available for academic. Learning objectives to appreciate the concept underlying dta metaanalytic.
Using quadas2 and calculating estimates of diagnostic test accuracy lecture. Metaanalysis of diagnostic test accuracy studies with. A sas macro for metaanalysis of diagnostic accuracy studies, contains. The available software programs for diagnostic metaanalysis with the bivariate model or the hsroc model include r mada package, stata midas or metandi modules or sas nlmixed procedure or metadas macros 24,25. If you are using the official meta analysis commands in stata 16, the collection of stata journal articles is still valuable because the collection contains information about meta analysis, and not just information on the communitycontributed meta analysis commands. The hsroc curves can be plotted through the revman using the parameter estimates obtained from these softwares as input values. Video overview comprehensive metaanalysis software. The online pubmed, medline, embase, cnki and wanfang. Researchers have prepared macros or modules for statistical models for metaanalysis of data from diagnostic test accuracy studies for several statistical analysis software programs. If you are using the official metaanalysis commands in stata 16, the collection of stata journal articles is still valuable because the collection contains information about metaanalysis, and not just information on the communitycontributed metaanalysis commands. How you do your network meta analysis in r will depend on the nature of your input data, number of competing diagnostic tests being compared in each study, whether or not you have any covariate information, whether or not you have study armlevel information only or studylevel information, etc. Diagnostic value of ca 199 and carcinoembryonic antigen for. Software for metaanalysis of dta studies cochrane screening.
These macros include procedures for basic analysis, for cumulative analysis, for. Meta analysis of diagnostic test accuracy presents many challenges. The current meta analysis was conducted in order to compare the diagnostic value of ca 199 and cea for the detection of pancreatic cancer. Learn how to metaanalyze odds ratios in stata using metan.
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