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Final Presentation Group 2 Porto, 2 nd May 2007 Medical Faculty of Oporto

the reporting of Diagnostic accuracy studies in gastroenterology and hepatology literature . A STARD assessment. Final Presentation Group 2 Porto, 2 nd May 2007 Medical Faculty of Oporto. Topics. Introduction Methods Results Discussion and Conclusions Acknowledgements. Introduction.

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Final Presentation Group 2 Porto, 2 nd May 2007 Medical Faculty of Oporto

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  1. the reporting of Diagnostic accuracy studies in gastroenterology and hepatology literature . A STARD assessment Final Presentation Group 2 Porto, 2nd May 2007 Medical Faculty of Oporto

  2. Topics • Introduction • Methods • Results • Discussion and Conclusions • Acknowledgements

  3. Introduction As an extremely dynamic field, medicine evolves each day, integrating new ideas and concepts which come from all over the world Gastroenterology and hepatology are medical specializations concerned with the diagnosis and treatment of diseases of the digestive tract and organs Diagnostic tests play a crucial role in the accurate diagnose of diseases

  4. Introduction The number of existing diagnostic tests has grown over the past few years1 In January 2003, the guide for reporting studies of diagnostic accuracy Standards for Reporting of Diagnostic Accuracy (STARD) was published1 The objective of the STARD initiative is to improve the quality of reporting of studies of diagnostic accuracy1 1- Bossuyt, P; Reitsma, J; Bruns, D; Gatsonis, C; Glasziou, P; Irwig, L; Lijmer, J; Moher, D; Rennie, D; de Vet, H, Towards complete and accurate reporting o studies of diagnostic accuracy: the STARD initiative; Annals of internal medicine; Volume 138, 2003.

  5. introduction Bossuyt, P; Reitsma, J; Bruns, D; Gatsonis, C; Glasziou, P; Irwig, L; Lijmer, J; Moher, D; Rennie, D; de Vet, H, Towards complete and accurate reporting o studies of diagnostic accuracy: the STARD initiative; Annals of internal medicine; Volume 138, 2003.

  6. introduction Objectives Evaluate the quality of the articles which evaluate diagnostic tests in Gastroenterology and Hepatology on journals with the highest impact factor in the past 12 years based on the STARD checklist, and unveil if there was evolution in this type of studies Assess if the STARD initiative had influence in the articles or not 1 - Bossuyt, P; Reitsma, J; Bruns, D; Gatsonis, C; Glasziou, P; Irwig, L; Lijmer, J; Moher, D; Rennie, D; de Vet, H, Towards complete and accurate reporting o studies of diagnostic accuracy: the STARD initiative; Annals of internal medicine; Volume 138, 2003.

  7. Topics • Introduction • Methods • Results • Discussion and Conclusions • Acknowledgements

  8. Methods • Article search • Selection of abstracts • Article evaluation

  9. Articlesearch Initial Query for studies of diagnostic accuracy Definition of inclusion parameters • Restriction to the five journals of gastroenterology and hepatology with the highest impact factor • Restriction to diagnostic tests in humans

  10. article search Initial Query (((((((((((("sensitivity and specificity"[All Fields] OR "sensitivity and specificity/standards"[All Fields]) OR "specificity"[All Fields]) OR "screening"[All Fields]) OR "false positive"[All Fields]) OR "false negative"[All fields]) OR "accuracy"[All Fields]) OR (((("predictive value"[All Fields] OR "predictive value of tests"[All Fields]) OR "predictive value of tests/standards"[All Fields]) OR "predictive values"[All Fields]) OR "predictive values of tests"[All Fields])) OR (("reference value"[All Fields] OR "reference values"[All Fields]) OR "reference values/standards"[All Fields)) OR (((((((((("roc"[All Fields] OR "roc analyses"[All Fields]) OR "roc analysis"[All fields]) OR "roc and"[All fields]) OR "roc area"[All fields]) OR "roc auc"[All Fields]) OR "roc characteristics"[All Fields]) OR "roc curve"[All Fields]) OR "roc curve method"[All Fields]) OR "roc curves"[All Fields]) OR "roc estimated"[All Fields]) OR "roc evaluation"[All Fields])) OR "likelihood ratio"[All Fields]) Ref:Dévillé WL, Buntins F, Bouter LM, Montori, VM, de Vet H, Windt DAWM, Bezemer PD. Conducting systematic reviews of diagnostic studies: didactic guidelines, BMC medical research methodology 2002, 2:9

  11. article search Initial Query (((((((((((("sensitivity and specificity"[All Fields] OR "sensitivity and specificity/standards"[All Fields]) OR "specificity"[All Fields]) OR "screening"[All Fields]) OR "false positive"[All Fields]) OR "false negative"[All fields]) OR "accuracy"[All Fields]) OR (((("predictive value"[All Fields] OR "predictive value of tests"[All Fields]) OR "predictive value of tests/standards"[All Fields]) OR "predictive values"[All Fields]) OR "predictive values of tests"[All Fields])) OR (("reference value"[All Fields] OR "reference values"[All Fields]) OR "reference values/standards"[All Fields)) OR (((((((((("roc"[All Fields] OR "roc analyses"[All Fields]) OR "roc analysis"[All fields]) OR "roc and"[All fields]) OR "roc area"[All fields]) OR "roc auc"[All Fields]) OR "roc characteristics"[All Fields]) OR "roc curve"[All Fields]) OR "roc curve method"[All Fields]) OR "roc curves"[All Fields]) OR "roc estimated"[All Fields]) OR "roc evaluation"[All Fields])) OR "likelihood ratio"[All Fields]) AND (Humans[MeSH])

  12. Articlesearch Year 1994 Articles Found – 174 Query parameters: (…) 1994 [Publication Date] AND (GASTROENTEROLOGY [Journal] OR HEPATOLOGY [Journal] OR GUT [Journal] OR GASTROINTEST ENDOSC [Journal] OR J HEPATOL [Journal])

  13. Articlesearch 1994 – 174 1995 – 144 1996 – 168 1997 – 167 1998 – 129 1999 – 180 2000 – 170 2001 – 144 2002 – 165 • Journals with highest occurence: • Gastroenterol • Hepatol • Gut 2003 – 140 2004 – 261 2005 – 299

  14. Methods • Article search • Selection of abstracts • Article evaluation

  15. Selection Of abstracts

  16. Selection Of abstracts • Non-excluded and non-included abstracts were listed along with reasons of non-inclusion and added to the data base on SPSS

  17. Methods • Article search • Selection of abstracts • Article evaluation

  18. Article evaluation

  19. Topics • Introduction • Methods • Results • Discussion and Conclusions • Acknowledgements

  20. results

  21. results Comparison between excluded and included articles Reasons for non-inclusion Does not assess diagnostic tests Missing abstract Other 102 abstracts not excluded from 300 found

  22. results Agreement between abstract reviewers Rate of agreement between reviewers – 84,3%

  23. results Comparison between excluded and included articles Exclusion reasons (%) Does not assess diagnostic tests Missingarticle 78 articles included from 102 abstracts not excluded

  24. results Agreement between article reviewers Obtained ICC value is in accordance with ICC to be expected by Smidt, N. Expected ICC = 0,79 [95% CI: 0,62 to 0,89]1 1 - Smidt, N.; Rutjes, A.; van der Windt, D.; Ostelo, R.; Bossuyt, P; Reitsma, J.; Bouter, L; de Vet, H; Reproducibility of the STARD checklist: an instrument to assess the quality of reporting of diagnostic accuracy studies; BMC medical research methodology; 2006

  25. results Evolution of the article’s score by mean

  26. results Evolution of the article’s score by median

  27. results Individual STARD items absence percentage Items with highest absence (i13, i24) refer to reproducibility issues

  28. Topics • Introduction • Methods • Results • Discussion and Conclusions • Acknowledgements

  29. Discussion and conclusions STARD did not had a significant effect in the article’s quality • Insufficient time span between the STARD publishing (2003) and the current date • The small evolution in the article’s quality is likely to be a consequence of other factors, not taken into account in this study This study should be repeated in a wider time span

  30. Discussion and conclusions The quality of the this kind of articles in the journals with the highest impact factors is not as positive as expected • The credibility of these articles may be compromised • The results presented may be misleading

  31. Discussion and conclusions The STARD items referring to reproducibility issues are highly absent • The studies might be difficult to reproduce, which may lead to difficulties in the repeating of the studies by other researchers and therefore may impede verification of results • There is the possibility of the diagnostic tests assessed to be inaccurate

  32. Topics • Introduction • Methods • Results • Discussion and Conclusions • Acknowledgements

  33. Acknowledgments • Cristina Santos, MD • Altamiro da Costa Pereira, PhD MD

  34. Staff Authors Adriana Meneses Ana Fragoeiro André Carvalho Daniela Machado Eduardo Vilela InêsGonçalves JoãoSarmento Luís Santos Manuel Pinto Pedro Alves Sara Ferreira Tiago Taveira Orientation Cristina Santos, MD Supervisor Altamiro da Costa Pereira, PhD MD Porto, 2nd May 2007 Medical Faculty of Oporto

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