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Terry J. Quinn

Publications and source records attributed to Terry J. Quinn.

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MetaBayesDTA: Codeless Bayesian meta-analysis of test accuracy, with or without a gold standard

Introduction: Despite their applicability, statistical models used for the meta-analysis of test accuracy require specialised knowledge to implement, with the necessary level of expertise having recently increased. This is due to the development and recommendation to use more sophisticated methods; such as those in Version 2 of the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy. This paper describes a web-based application that extends the functionality of previous applications, making many advanced analysis methods more accessible. Methods: We sought to create an extended, stand-alone, Bayesian version of MetaDTA, which (i) has the benefits of previously proposed applications and addresses key limitations of them, (ii) is accessible to researchers who do not have the specific expertise required to fit such models, and (iii) is suitable for experienced analysts. We created the application using Shiny and Stan. Results: We created MetaBayesDTA (https://crsu.shinyapps.io/MetaBayesDTA/), which allows users to conduct meta-analysis of test accuracy, with or without a gold standard. The application addresses several key limitations of other applications. For instance, for the bivariate model, one can conduct subgroup analysis, univariate meta-regression, and comparative test accuracy evaluation. Meanwhile, for the model which does not assume a perfect gold standard, the application can account for the fact that studies use different reference tests. Conclusions: Due to its user-friendliness and broad array of features, MetaBayesDTA should appeal to a wide variety of researchers. We anticipate that the application will encourage wider use of more advanced methods, which ultimately should improve the quality of test accuracy reviews.

stat.AP

Meta-analysis of dichotomous and ordinal tests without a gold standard

Standard methods for the meta-analysis of medical tests without a gold standard are limited to dichotomous data. Multivariate probit models are used to analyze correlated binary data, and can be extended to multivariate ordered probit models to model ordinal data. Within the context of an imperfect gold standard, they have previously been used for the analysis of dichotomous and ordinal tests in a single study, and for the meta-analysis of dichotomous tests. In this paper, we developed a hierarchical, latent class multivariate probit model for the simultaneous meta-analysis of ordinal and dichotomous tests without assuming a gold standard. The model can accommodate a hierarchical partial pooling model on the conditional within-study correlations, enabling one to obtain summary estimates of joint test accuracy. Dichotomous tests use probit regression likelihoods and ordinal tests use ordered probit regression likelihoods. We fitted the models using Stan, which uses a state-of-the-art Hamiltonian Monte Carlo algorithm. We applied the models to a dataset in which studies evaluated the accuracy of tests, and test combinations, for deep vein thrombosis. We first demonstrated the issues with dichotomising test accuracy data a priori without a gold standard by fitting models which dichotomised the ordinal test data, and then we applied models which do not dichotomise the data. Furthermore, we fitted and compared a variety of other models, including those which assumed conditional independence and dependence between tests, and those assuming perfect and an imperfect gold standard.

stat.AP