Figure 3 shows a summary graph of the Quality Assessment for Diagnostic Accuracy Studies (QUADAS) ratings for all 104 studies. A majority of studies uniformly applied a reference test (i.e., coronary angiography) that was independently performed, used blinded interpretation of the reference and index test, and had sufficient detail about the index test to allow for replicability. Many studies had a high risk of spectrum bias (i.e., patient representation of those who would receive the test in practice), a poor description of study withdrawals, unclear descriptions of clinical data available during test interpretation, and lacked descriptions of uninterpretable or intermediate test results. There is a possibility that sensitivity and specificity values may be biased because of a nonrandom selection of subjects from the population of interest; however, available data did not provide sufficient information to consider possible adjustment for such bias.

Figure 3QUADAS elements used to rate diagnostic accuracy

From: Results

Cover of Noninvasive Technologies for the Diagnosis of Coronary Artery Disease in Women
Noninvasive Technologies for the Diagnosis of Coronary Artery Disease in Women [Internet].
Comparative Effectiveness Reviews, No. 58.
Dolor RJ, Patel MR, Melloni C, et al.

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