{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:39:29Z","timestamp":1792291169381,"version":"4.4.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2015,6,26]],"date-time":"2015-06-26T00:00:00Z","timestamp":1435276800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Stat Methods Med Res"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:p>Hierarchical models such as the bivariate and hierarchical summary receiver operating characteristic (HSROC) models are recommended for meta-analysis of test accuracy studies. These models are challenging to fit when there are few studies and\/or sparse data (for example zero cells in contingency tables due to studies reporting 100% sensitivity or specificity); the models may not converge, or give unreliable parameter estimates. Using simulation, we investigated the performance of seven hierarchical models incorporating increasing simplifications in scenarios designed to replicate realistic situations for meta-analysis of test accuracy studies. Performance of the models was assessed in terms of estimability (percentage of meta-analyses that successfully converged and percentage where the between study correlation was estimable), bias, mean square error and coverage of the 95% confidence intervals. Our results indicate that simpler hierarchical models are valid in situations with few studies or sparse data. For synthesis of sensitivity and specificity, univariate random effects logistic regression models are appropriate when a bivariate model cannot be fitted. Alternatively, an HSROC model that assumes a symmetric SROC curve (by excluding the shape parameter) can be used if the HSROC model is the chosen meta-analytic approach. In the absence of heterogeneity, fixed effect equivalent of the models can be applied.<\/jats:p>","DOI":"10.1177\/0962280215592269","type":"journal-article","created":{"date-parts":[[2015,6,26]],"date-time":"2015-06-26T21:41:22Z","timestamp":1435354882000},"page":"1896-1911","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":209,"title":["Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data"],"prefix":"10.1177","volume":"26","author":[{"given":"Yemisi","family":"Takwoingi","sequence":"first","affiliation":[{"name":"Public Health, Epidemiology and Biostatistics, University of Birmingham, Edgbaston, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boliang","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard D","family":"Riley","sequence":"additional","affiliation":[{"name":"Research Institute of Primary Care and Health Sciences, Keele University, Staffordshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan J","family":"Deeks","sequence":"additional","affiliation":[{"name":"Public Health, Epidemiology and Biostatistics, University of Birmingham, Edgbaston, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,6,26]]},"reference":[{"key":"bibr1-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.02.022"},{"key":"bibr2-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1002\/sim.942"},{"key":"bibr3-0962280215592269","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-149-12-200812160-00008"},{"key":"bibr4-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.09.013"},{"key":"bibr5-0962280215592269","unstructured":"Macaskill P, Gatsonis C, Deeks JJ, et\u00a0al. Chapter 10: analysing and presenting results. In: Deeks JJ, Bossuyt PM and Gatsonis C (eds)\n                      Cochrane handbook for systematic reviews of diagnostic test accuracy\n                      . Version 1.0. The Cochrane Collaboration, 2010. http:\/\/srdta.cochrane.org\/."},{"key":"bibr6-0962280215592269","unstructured":"Dahabreh IJ, Trikalinos TA, Lau J, et\u00a0al.\n                      An empirical assessment of bivariate methods for meta-analysis of test accuracy\n                      . Rockville, MD: Agency for Healthcare Research and Quality (US), 2012. Publication No. 12(13)-EHC136-EF."},{"key":"bibr7-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2006.06.011"},{"key":"bibr8-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X08323917"},{"key":"bibr9-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.03.016"},{"key":"bibr10-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X08319957"},{"key":"bibr11-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4055"},{"key":"bibr12-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X09353452"},{"key":"bibr13-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1177\/0962280213492588"},{"key":"bibr14-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3858"},{"key":"bibr15-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-7-3"},{"key":"bibr16-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.05.015"},{"key":"bibr17-0962280215592269","unstructured":"Dahabreh IJ, Chung M, Kitsios GD, et\u00a0al.\n                      Comprehensive overview of methods and reporting of meta-analyses of test accuracy\n                      . Rockville, MD: Agency for Healthcare Research and Quality (US), 2012. Publication No. 12-EHC044-EF."},{"key":"bibr18-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780121403"},{"key":"bibr19-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1093\/biostatistics\/kxl004"},{"key":"bibr20-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780122405"},{"key":"bibr21-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2003.12.019"},{"key":"bibr22-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3631"},{"key":"bibr23-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2009.06.509"},{"key":"bibr24-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-1081-6"},{"key":"bibr25-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.01.016"},{"key":"bibr26-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38793.637789.2F"},{"key":"bibr27-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2673"},{"key":"bibr28-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1177\/0962280214562146"},{"key":"bibr29-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.02.007"},{"key":"bibr30-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.csda.2014.09.021"},{"key":"bibr31-0962280215592269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2008.05.011"}],"container-title":["Statistical Methods in Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0962280215592269","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0962280215592269","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0962280215592269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:48:05Z","timestamp":1777679285000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0962280215592269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,26]]},"references-count":31,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1177\/0962280215592269"],"URL":"https:\/\/doi.org\/10.1177\/0962280215592269","relation":{},"ISSN":["0962-2802","1477-0334"],"issn-type":[{"value":"0962-2802","type":"print"},{"value":"1477-0334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,26]]}}}