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• W2893167164 abstract "Background and ObjectiveMeta-analysis may produce estimates that are unrepresentative of a test's performance in practice. Tailored meta-analysis (TMA) circumvents this by deriving an applicable region for the practice and selecting the studies compatible with the region. It requires the test positive rate, r and prevalence, p being estimated for the setting but previous studies have assumed their independence. The aim is to investigate the effects a correlation between r and p has on estimating the applicable region and how this affects TMA.MethodsSix methods for estimating 99% confidence intervals (CI) for r and p were investigated: Wilson's ± Bonferroni correction, Clopper-Pearson's ± Bonferroni correction, and Hotelling's T2 statistic ± continuity correction. These were analyzed in terms of the coverage probability using simulation trials over different correlations, sample sizes, and values for r and p. The methods were then applied to two published meta-analyses with associated practice data, and the effects on the applicable region, studies selected, and summary estimates were evaluated.ResultsHotelling's T2 statistic with a continuity correction had the highest median coverage (0.9971). This and the Clopper-Pearson method with a Bonferroni correction both had coverage consistently above 0.99. The coverage of Hotelling's CI's varied the least across different correlations. For both meta-analyses, the number of studies selected was largest when Hotelling's T2 statistic was used to derive the applicable region. In one instance, this increased the sensitivity by over 4% compared with TMA estimates using other methods.ConclusionTMA returns estimates that are tailored to practice providing the applicable region is accurately defined. This is most likely when the CI for r and p are estimated using Hotelling's T2 statistic with a continuity correction. Potentially, the applicable region may be obtained using routine electronic health data." @default.
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• W2893167164 date "2019-02-01" @default.
• W2893167164 modified "2023-09-25" @default.
• W2893167164 title "Tailored meta-analysis: an investigation of the correlation between the test positive rate and prevalence" @default.
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• W2893167164 doi "https://doi.org/10.1016/j.jclinepi.2018.09.013" @default.
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