Diagnostic accuracy meta-analysis: a review of the basic principles of interpretation and application

Evidence-based practice has become increasingly important in all aspects of medicine. The availability and variety of diagnostic tests in cardiovascular practice are increasing rapidly and are therefore under scrutiny in the literature. Diagnostic meta-analysis is used to summarise and combine results from multiple studies. The analytical techniques for diagnostic meta-analysis differ from other meta-analyses because the measures of diagnostic accuracy (sensitivity and specificity) are unique to diagnostics. However, the benchmark for diagnostic meta-analysis techniques continues to move forward, making interpretation and application of the results difficult for clinicians. This article explains the terminology of the current standards in diagnostic meta-analysis, and outlines the principles of applying these results to clinical practice.