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Stat Med. 2008 Feb 28;27(5):687-97.

We should not pool diagnostic likelihood ratios in systematic reviews.

Author information

  • 1Department of Clinical Epidemiology and Biostatistics, P.O. Box 22700, 1100 DD Amsterdam, The Netherlands. a.h.zwinderman@amc.uva.nl

Abstract

Some authors plead for the explicit use of diagnostic likelihood ratios to describe the accuracy of diagnostic tests. Likelihood ratios are also preferentially used by some journals, and, naturally, are also used in meta-analysis. Although likelihood ratios vary between zero and infinity, meta-analysis is complicated by the fact that not every combination in Re(+) is appropriate. The usual bivariate meta-analysis with a bivariate normal distribution can sometimes lead to positive probability mass at values that are not possible. We considered, therefore, three different statistical models that do not suffer from this drawback. All three approaches are so complicated that we advise to consider meta-analysis of sensitivity and specificity values instead of likelihood ratios.

PMID:
17611957
[PubMed - indexed for MEDLINE]
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