Summary Receiver Operating Characteristic Curve (January 21, 2005) Category: Systematic overviews
In the past week, I have had two inquiries about how to perform a meta-analysis of studies of a diagnostic test. An intriguing idea that I discovered in researching this is the use of the Receiver Operating Characteristic (ROC) curve to summarize the results of the studies. Each study will have its own sensitivity and specificity, and plotting the sensitivity/specificity pairs on the coordinates of an ROC plot, along with some reference lines, will help you to evaluate the degree of heterogeneity of the studies, among other things. An example of this type of plot appears on the web at
and there are a couple of references that discuss this approach.
- Systematic reviews in health care: Systematic reviews of evaluations of diagnostic and screening tests. Deeks JJ. British Medical Journal 2001: 323(7305); 157-62. [Medline] [Full text] [PDF]
- Conducting systematic reviews of diagnostic studies: didactic guidelines. Deville WL, Buntinx F, Bouter LM, Montori VM, De Vet HC, Van Der Windt DA, Bezemer P. BMC Med Res Methodol 2002: 2(1); 9. [Medline] [Abstract] [Full text] [PDF]
Some additional references on the problems of meta-analysis for diagnostic tests are:
- Reporting of measures of accuracy in systematic reviews of diagnostic literature. Honest H, Khan KS. BMC Health Serv Res 2002: 2(1); 4. [Medline] [Abstract] [Full text] [PDF]
- Pooling data for number needed to treat: no problems for apples. Moore RA, Gavaghan DJ, Edwards JE, Wiffen P, McQuay HJ. BMC Med Res Methodol 2002: 2(1); 2. [Medline] [Abstract] [Full text] [PDF]
- Simpson's paradox and calculation of number needed to treat from meta-analysis. Cates CJ. BMC Med Res Methodol 2002: 2(1); 1. [Medline] [Abstract] [Full text] [PDF]
This webpage was written by Steve Simon and was last modified on 07/08/2008.