How to conduct a systematic review for diagnostic studies with technologies? 

In brief 

Developing guidelines based on a thorough analysis of the data found in diagnostic research literature searches reports, methodological standards for judging diagnostic research, techniques for statistically pooling data on diagnostic accuracy, and techniques for examining heterogeneity. In addition, this blog offers a thorough analysis of diagnostic research connected to technologies. 

Introduction 

Despite being a crucial component of evidence-based healthcare, systematic reviews and meta-analyses are still somewhat mysterious. What factors led the writers to choose some research over others? How did they combine the results? How did several unimportant results become abruptly important? This blog explains other connected intrigues and delves into more depth ^(1).  

The following investigations have been conducted to evaluate the efficacy of diagnostic tests: A systematic review should include all known data, so a thorough literature search is required. The reviewer must create a search strategy based on a detailed account of the subjects who will receive the test of interest, the diagnostic test and its accuracy predictions, the target illness, and the study design. These components are typically stated in the review’s criteria for including primary research. Electronic literature sources will be used in the inquiry. However, because computerized libraries only identify a subset of all accessible books, the search should be supplemented with additional resources⁽²⁾. 

A review earns the adjective systematic if it is based on a formulated question, identifies relevant studies, appraises their quality and summarizes the evidence using the explicit methodology. The direct and systematic approach distinguishes systematic reviews from traditional reviews and commentaries. Whenever we use the term review in this paper, it means a systematic review. Reviews should never be done in any other way. Here are the general steps for conducting a systematic review of diagnostic studies with technologies: 

• Develop search strategy: Develop a comprehensive search strategy that includes keywords, Medical Subject Headings (MeSH) terms, and other relevant search terms for the technology and the condition being diagnosed. The search strategy should be applied to multiple databases, such as PubMed, EMBASE, and Cochrane Library. 
• Select studies: Screen the titles and abstracts identified in the search to identify potentially relevant studies. Then, read the full text of the studies to determine whether they meet the inclusion and exclusion criteria. 
• Extract data: Extract data from the studies that meet the inclusion criteria. This may include study characteristics (e.g., sample size, study design), participant characteristics (e.g., age, gender, disease status), intervention details (e.g., type of technology used), and outcome measures (e.g., sensitivity, specificity). 
• Assess study quality: Assess the quality of the studies using established criteria, such as the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. This will help determine the risk of bias and the applicability of the studies to the research question. 
• Analyze data: Conduct a meta-analysis if possible. This involves pooling the data from multiple studies and calculating summary estimates of diagnostic accuracy (e.g., sensitivity, specificity). 

• Interpret findings: Interpret the systematic review’s results in the context of the research question. This may include discussing the strengths and limitations of the studies included in the review, the overall quality of evidence, and potential implications for clinical practice. 
• Report results: Write up the results of the systematic review clearly and concisely. This should include a detailed description of the search strategy, study selection process, data extraction, and quality assessment procedures. The findings should be presented in a way that is accessible to the intended audience (e.g., clinicians, researchers, and policymakers). 

Conclusions 

The impacts of validity criteria on diagnostic accuracy measures and subgroup analysis contribute actual proof to diagnostic accuracy research. Until better-conducted studies are released, generating a pooled estimate, the possible approximation of the test’s accuracy provides doctors with valuable information. However, the viewer should remember that proof of the impact of various internal or external validity elements on diagnostic precision findings is still restricted. 

The development of guidelines for systematic reviews of tests with continuous or ordinal outcomes, reviews of diagnostic methods involving multiple tests, and reviews of diagnostic test reliability remains challenging, as methodology is still restricted or non-existent⁽³⁾. 

About Pubrica 

The team of researchers and writers at Pubrica creates scientific and medical study papers that can serve as invaluable resources for practitioners and authors. The introduction is written and edited with the assistance of Pubrica medical writers, who inform the viewer of any gaps in the study area that need to be filled. Our specialists are conscious of the order in which the general topic, the issue, and the background are followed by the narrow subject where the hypothesis is stated. 

References 

1. Devillé WL, Buntinx F, Bouter LM, Montori VM, de Vet HC, van der Windt DA, Bezemer PD. Conducting systematic reviews of diagnostic studies: didactic guidelines. BMC Med Res Methodol. 2002 Jul 3;2:9. doi: 10.1186/1471-2288-2-9. PMID: 12097142; PMCID: PMC117243. 

2. Aggarwal, Ravi, et al. “Diagnostic accuracy of deep learning in medical imaging: a systematic review and meta-analysis.” NPJ digital medicine 4.1 (2021): 65. 

3. Campbell, Jared M., et al. “Diagnostic test accuracy: methods for systematic review and meta-analysis.” JBI Evidence Implementation 13.3 (2015): 154-162.