CommentarySystematic reviews of diagnostic accuracy studies require study by study examination: first for heterogeneity, and then for sources of heterogeneity
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2021, Journal of Clinical EpidemiologyCitation Excerpt :Another issue with diagnostic meta-analyses is publication bias. We noticed very high levels of asymmetry under simulated heterogeneity, and this is not surprising because Begg [41] concluded, based on data from Deeks et al. [42], that the validity of tests of publication bias is compromised when the DOR is high, cutoff value is extreme, and prevalence of disease is low, reflecting the fact that these features tend to lead to extreme 2 × 2 tables with low cell frequencies in which the undesired correlation between DOR and its variance is most apparent. We therefore advocate caution in concluding that asymmetry indicates publication bias when these circumstances are present.
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