Diagnostic accuracy meta-analysis: review of an important tool in radiological research and decision making

The importance of evidence-based diagnostic practice has been increasingly recognised over the past decade. Meta-analyses are used to summarise and assess the literature and are therefore particularly important tools in radiological research. Diagnostic radiology is driven by emerging technologies that are increasingly under scrutiny in the radiological literature. Correspondingly, diagnostic meta-analyses are better at addressing the intricacies of diagnostic accuracy measures, whilst retaining robust methodology. The ability to interpret results for application to clinical practice is increasingly important for radiology owing to the close relationship with the diagnostic process. However, confusing terminology and a lack of understanding of the principles of diagnostic meta-analysis leads to difficulty in interpretation by clinicians. Hierarchical summary receiver operating characteristic analysis is becoming the standard method for diagnostic test meta-analysis. This article explains the basic principles of interpreting diagnostic meta-analyses.