Individual patient data meta-analysis of diagnostic and prognostic studies in obstetrics, gynaecology and reproductive medicine

被引：26

作者：

Broeze, Kimiko A. ^{[1
,2
]}

Opmeer, Brent C. ^{[2
]}

Bachmann, Lucas M. ^{[3
]}

Broekmans, Frank J. ^{[4
]}

Bossuyt, Patrick M. M. ^{[2
]}

Coppus, Sjors F. P. J. ^{[1
,2
]}

Johnson, Neil P. ^{[5
]}

Khan, Khalid S. ^{[6
,7
]}

ter Riet, Gerben ^{[8
]}

van der Veen, Fulco ^{[1
]}

van Wely, Madelon ^{[1
]}

Mol, Ben W. J. ^{[1
,2
]}

机构：

[1] Univ Amsterdam, Acad Med Ctr, Ctr Reprod Med, Dept Obstet & Gynaecol, NL-1105 AZ Amsterdam, Netherlands

[2] Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol Biostat & Bioinformat, NL-1105 AZ Amsterdam, Netherlands

[3] Univ Bern, Div Epidemiol & Biostat, Dept Social & Prevent Med, CH-3012 Bern, Switzerland

[4] Univ Med Ctr, Dept Reprod Med & Gynaecol, Utrecht, Netherlands

[5] Univ Auckland, Auckland Hosp, Dept Obstet & Gynaecol, Auckland 1, New Zealand

[6] Univ Birmingham, Dept Obstet & Gynaecol, Birmingham, W Midlands, England

[7] Birmingham Womens Hosp, Birmingham, W Midlands, England

[8] Univ Amsterdam, Acad Med Ctr, Dept Gen Med, NL-1105 AZ Amsterdam, Netherlands

来源：

BMC MEDICAL RESEARCH METHODOLOGY | 2009年 / 9卷

关键词：

IN-VITRO FERTILIZATION; POOR OVARIAN RESPONSE; FOLLICLE-STIMULATING-HORMONE; SYSTEMATIC REVIEWS; SPECTRUM BIAS; ENDOMETRIAL CANCER; TUBAL PATHOLOGY; CLINICAL-TEST; ACCURACY; TESTS;

D O I：

10.1186/1471-2288-9-22

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Background: In clinical practice a diagnosis is based on a combination of clinical history, physical examination and additional diagnostic tests. At present, studies on diagnostic research often report the accuracy of tests without taking into account the information already known from history and examination. Due to this lack of information, together with variations in design and quality of studies, conventional meta-analyses based on these studies will not show the accuracy of the tests in real practice. By using individual patient data (IPD) to perform meta-analyses, the accuracy of tests can be assessed in relation to other patient characteristics and allows the development or evaluation of diagnostic algorithms for individual patients. In this study we will examine these potential benefits in four clinical diagnostic problems in the field of gynaecology, obstetrics and reproductive medicine. Methods/design: Based on earlier systematic reviews for each of the four clinical problems, studies are considered for inclusion. The first authors of the included studies will be invited to participate and share their original data. After assessment of validity and completeness the acquired datasets are merged. Based on these data, a series of analyses will be performed, including a systematic comparison of the results of the IPD meta-analysis with those of a conventional meta-analysis, development of multivariable models for clinical history alone and for the combination of history, physical examination and relevant diagnostic tests and development of clinical prediction rules for the individual patients. These will be made accessible for clinicians. Discussion: The use of IPD meta-analysis will allow evaluating accuracy of diagnostic tests in relation to other relevant information. Ultimately, this could increase the efficiency of the diagnostic work-up, e.g. by reducing the need for invasive tests and/or improving the accuracy of the diagnostic workup. This study will assess whether these benefits of IPD meta-analysis over conventional meta-analysis can be exploited and will provide a framework for future IPD meta-analyses in diagnostic and prognostic research.

引用

页数：11

共 55 条

[1]

[Anonymous], 2009, Modern epidemiology

[2] Probability analysis for diagnosis of endometrial hyperplasia and cancer in postmenopausal bleeding: an approach for a rational diagnostic workup [J].