Bivariate Random-Effects Meta-analysis of Sensitivity and Specificity with the Bayesian SAS PROC MCMC: Methodology and Empirical Evaluation in 50 Meta-analyses

Background and Objective: Meta-analysis allows for summarizing the sensitivities and specificities from several primary diagnostic test accuracy studies quantitatively. This article presents and evaluates a full Bayesian method for bivariate random-effects meta-analysis of sensitivity and specificit...

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Bibliographic Details
Published in:Medical decision making 2013-07, Vol.33 (5), p.692-701
Main Author: Menke, Jan
Format: Article
Language:English
Subjects:
Bayes Theorem
Empirical Research
Markov Chains
Models, Theoretical
Sensitivity and Specificity
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Summary:Background and Objective: Meta-analysis allows for summarizing the sensitivities and specificities from several primary diagnostic test accuracy studies quantitatively. This article presents and evaluates a full Bayesian method for bivariate random-effects meta-analysis of sensitivity and specificity with SAS PROC MCMC. Methods: First, the formula of the bivariate random-effects model is presented. Then its implementation with the Bayesian SAS PROC MCMC is empirically evaluated, using the published 2 × 2 count data of 50 meta-analyses. The convergence of the Markov chains is analyzed visually and qualitatively. The results are compared with a Bayesian WinBUGS approach, using the Bland-Altman analysis for assessing agreement between 2 methods. Results: The 50 meta-analyses covered broad ranges of pooled sensitivity (17.4% to 98.8%) and specificity (60.0% to 99.7%), and the between-study heterogeneity varied as well. In all meta-analyses, the Markov chains converged well. The meta-analytic results from the SAS PROC MCMC and the WinBUGS random-effects approaches were nearly similar, showing close 95% limits of agreement for the pooled sensitivity (–0.06% to 0.05%) and specificity (–0.05% to 0.05%) without significant differences (P > 0.05). This indicates that the bivariate model is well implemented with both different statistical programs, without systematic differences arising from program attributes. Conclusions: As alternative to a WinBUGS approach, the Bayesian SAS PROC MCMC is well suited for bivariate random-effects meta-analysis of sensitivity and specificity.
ISSN:0272-989X
1552-681X
DOI:10.1177/0272989X13475719