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  • Cochran's Q test was useful...
    Cohen, Jérémie F; Chalumeau, Martin; Cohen, Robert; Korevaar, Daniël A; Khoshnood, Babak; Bossuyt, Patrick M.M

    Journal of clinical epidemiology, 03/2015, Letnik: 68, Številka: 3
    Journal Article

    Abstract Objectives Empirical evaluations have demonstrated that diagnostic accuracy frequently shows significant heterogeneity between subgroups of patients within a study. We propose to use Cochran's Q test to assess heterogeneity in diagnostic likelihood ratios (LRs). Study Design and Setting We reanalyzed published data of six articles that showed within-study heterogeneity in diagnostic accuracy. We used the Q test to assess heterogeneity in LRs and compared the results of the Q test with those obtained using another method for stratified analysis of LRs, based on subgroup confidence intervals. We also studied the behavior of the Q test using hypothetical data. Results The Q test detected significant heterogeneity in LRs in all six example data sets. The Q test detected significant heterogeneity in LRs more frequently than the confidence interval approach (38% vs. 20%). When applied to hypothetical data, the Q test would be able to detect relatively small variations in LRs, of about a twofold increase, in a study including 300 participants. Conclusion Reanalysis of published data using the Q test can be easily performed to assess heterogeneity in diagnostic LRs between subgroups of patients, potentially providing important information to clinicians who base their decisions on published LRs.