How to Perform a Systematic Review and Meta-analysis of Diagnostic Imaging Studies

Abstract

A systematic review is a comprehensive search, critical evaluation, and synthesis of all the relevant studies on a specific (clinical) topic that can be applied to the evaluation of diagnostic and screening imaging studies. It can be a qualitative or a quantitative (meta-analysis) review of available literature. A meta-analysis uses statistical methods to combine and summarize the results of several studies. In this review, a 12-step approach to performing a systematic review (and meta-analysis) is outlined under the four domains: (1) Problem Formulation and Data Acquisition, (2) Quality Appraisal of Eligible Studies, (3) Statistical Analysis of Quantitative Data, and (4) Clinical Interpretation of the Evidence. This review is specifically geared toward the performance of a systematic review and meta-analysis of diagnostic test accuracy (imaging) studies.

Keywords: Diagnostic accuracy; ROC analysis; evidence-based medicine; evidence-based radiology; heterogeneity; literature search; meta-analysis; meta-regression; publication bias; receiver operating characteristic analysis; sensitivity analyses; subgroup analysis; systematic review; threshold effect.