Diagnostic accuracy of clinical illness for bovine respiratory disease (BRD) diagnosis in beef cattle placed in feedlots: A systematic literature review and hierarchical Bayesian latent-class meta-analysis

Diagnosis of bovine respiratory disease (BRD) in beef cattle placed in feedlots is typically based on clinical illness (CI) detected by pen-checkers. Unfortunately, the accuracy of this diagnostic approach (namely, sensitivity [Se] and specificity [Sp]) remains poorly understood, in part due to the absence of a reference test for ante-mortem diagnosis of BRD. Our objective was to pool available estimates of CI's diagnostic accuracy for BRD diagnosis in feedlot beef cattle while adjusting for the inaccuracy in the reference test. The presence of lung lesions (LU) at slaughter was used as the reference test. A systematic review of the literature was conducted to identify research articles comparing CI detected by pen-checkers during the feeding period to LU at slaughter. A hierarchical Bayesian latent-class meta-analysis was used to model test accuracy. This approach accounted for imperfections of both tests as well as the within and between study variability in the accuracy of Cl. Furthermore, it also predicted the Se-CI and Sp(CI) for future studies. Conditional independence between CI and LU was assumed, as these two tests are not based on similar biological principles. Seven studies were included in the meta-analysis. Estimated pooled Se-CI and Sp(CI) were 0.27 (95% Bayesian credible interval: 0.12-0.65) and 0.92 (0.72-0.98), respectively, whereas estimated pooled Se-LU and Sp(LU) were 0.91 (0.82-0.99) and 0.67 (0.64-0.79). Predicted Sea and Spa for future studies were 0.27 (0.01-0.96) and 0.92 (0.14-1.00), respectively. The wide credible intervals around predicted Se-CI and Sp(CI) estimates indicated considerable heterogeneity among studies, which suggests that pooled Se-CI and Sp(CI) are not generalizable to individual studies. In conclusion, CI appeared to have poor Se but high Sp for BRD diagnosis in feedlots. Furthermore, considerable heterogeneity among studies highlighted an urgent need to standardize BRD diagnosis in feedlots. (C) 2016 Elsevier B.V. All rights reserved.