Latent class models in diagnostic studies when there is no reference standard--a systematic review

Latent class models (LCMs) combine the results of multiple diagnostic tests through a statistical model to obtain estimates of disease prevalence and diagnostic test accuracy in situations where there is no single, accurate reference standard. We performed a systematic review of the methodology and reporting of LCMs in diagnostic accuracy studies. This review shows that the use of LCMs in such studies increased sharply in the past decade, notably in the domain of infectious diseases (overall contribution: 59%). The 64 reviewed studies used a range of differently specified parametric latent variable models, applying Bayesian and frequentist methods. The critical assumption underlying the majority of LCM applications (61%) is that the test observations must be independent within 2 classes. Because violations of this assumption can lead to biased estimates of accuracy and prevalence, performing and reporting checks of whether assumptions are met is essential. Unfortunately, our review shows that 28% of the included studies failed to report any information that enables verification of model assumptions or performance. Because of the lack of information on model fit and adequate evidence "external" to the LCMs, it is often difficult for readers to judge the validity of LCM-based inferences and conclusions reached.

Medienart:

E-Artikel

Erscheinungsjahr:

2014

Erschienen:

2014

Enthalten in:

Zur Gesamtaufnahme - volume:179

Enthalten in:

American journal of epidemiology - 179(2014), 4 vom: 15. Feb., Seite 423-31

Sprache:

Englisch

Beteiligte Personen:

van Smeden, Maarten [VerfasserIn]
Naaktgeboren, Christiana A [VerfasserIn]
Reitsma, Johannes B [VerfasserIn]
Moons, Karel G M [VerfasserIn]
de Groot, Joris A H [VerfasserIn]

Links:

Volltext

Themen:

Diagnostic tests, routine
Journal Article
Models, statistical
Prevalence
Reference standards
Research Support, Non-U.S. Gov't
Review
Sensitivity and specificity
Systematic Review

Anmerkungen:

Date Completed 17.03.2014

Date Revised 08.04.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1093/aje/kwt286

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM233030247