During the past 30 years, meta-analysis has been an indispensable tool for revealing the hidden meaning of our research literatures. The four articles in this special section on meta-analysis illus...

Meta-Analysis: A Constantly Evolving Research Integration Tool

The metafor package provides functions for conducting meta-analyses in R. The package includes functions for fitting the meta-analytic fixed- and random-effects models and allows for the inclusion of moderators variables (study-level covariates) in these models. Meta-regression analyses with continuous and categorical moderators can be conducted in this way. Functions for the Mantel-Haenszel and Peto's one-step method for meta-analyses of 2 x 2 table data are also available. Finally, the package provides various plot functions (for example, for forest, funnel, and radial plots) and functions for assessing the model fit, for obtaining case diagnostics, and for tests of publication bias.

Conducting Meta-Analyses in R with the metafor Package

Receiver operating characteristic (ROC) curves are useful tools to evaluate classifiers in biomedical and bioinformatics applications. However, conclusions are often reached through inconsistent use or insufficient statistical analysis. To support researchers in their ROC curves analysis we developed pROC, a package for R and S+ that contains a set of tools displaying, analyzing, smoothing and comparing ROC curves in a user-friendly, object-oriented and flexible interface. With data previously imported into the R or S+ environment, the pROC package builds ROC curves and includes functions for computing confidence intervals, statistical tests for comparing total or partial area under the curve or the operating points of different classifiers, and methods for smoothing ROC curves. Intermediary and final results are visualised in user-friendly interfaces. A case study based on published clinical and biomarker data shows how to perform a typical ROC analysis with pROC. pROC is a package for R and S+ specifically dedicated to ROC analysis. It proposes multiple statistical tests to compare ROC curves, and in particular partial areas under the curve, allowing proper ROC interpretation. pROC is available in two versions: in the R programming language or with a graphical user interface in the S+ statistical software. It is accessible at http://expasy.org/tools/pROC/
 under the GNU General Public License. It is also distributed through the CRAN and CSAN public repositories, facilitating its installation.

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pROC: an open-source package for R and S+ to analyze and compare ROC curves

The present article presents a meta-analytic test of intergroup contact theory. With 713 independent samples from 515 studies, the meta-analysis finds that intergroup contact typically reduces intergroup prejudice. Multiple tests indicate that this finding appears not to result from either participant selection or publication biases, and the more rigorous studies yield larger mean effects. These contact effects typically generalize to the entire outgroup, and they emerge across a broad range of outgroup targets and contact settings. Similar patterns also emerge for samples with racial or ethnic targets and samples with other targets. This result suggests that contact theory, devised originally for racial and ethnic encounters, can be extended to other groups. A global indicator of Allport's optimal contact conditions demonstrates that contact under these conditions typically leads to even greater reduction in prejudice. Closer examination demonstrates that these conditions are best conceptualized as an interrelated bundle rather than as independent factors. Further, the meta-analytic findings indicate that these conditions are not essential for prejudice reduction. Hence, future work should focus on negative factors that prevent intergroup contact from diminishing prejudice as well as the development of a more comprehensive theory of intergroup contact.

A meta-analytic test of intergroup contact theory.

The clinical performance of a laboratory test can be described in terms of diagnostic accuracy, or the ability to correctly classify subjects into clinically relevant subgroups. Diagnostic accuracy refers to the quality of the information provided by the classification device and should be distinguished from the usefulness, or actual practical value, of the information. Receiver-operating characteristic (ROC) plots provide a pure index of accuracy by demonstrating the limits of a test's ability to discriminate between alternative states of health over the complete spectrum of operating conditions. Furthermore, ROC plots occupy a central or unifying position in the process of assessing and using diagnostic tools. Once the plot is generated, a user can readily go on to many other activities such as performing quantitative ROC analysis and comparisons of tests, using likelihood ratio to revise the probability of disease in individual subjects, selecting decision thresholds, using logistic-regression analysis, using discriminant-function analysis, or incorporating the tool into a clinical strategy by using decision analysis.

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Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine.

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Statistical Methods for Meta‐Analysis

Preface. Acknowledgments. 1. Introduction. 1.1 Why This Book? 1.2 What Is Diagnostic Accuracy? 1.3 Landmarks in Statistical Methods for Diagnostic Medicine. 1.4 Software. 1.5 Topics not Covered in This Book. 1.6 Summary. I BASIC CONCEPTS AND METHODS. 2. Measures of Diagnostic Accuracy. 2.1 Sensitivity and Specificity. 2.2 The Combined Measures of Sensitivity and Specificity. 2.3 The ROC Curve. 2.4 The Area Under the ROC Curve. 2.5 The Sensitivity at a Fixed FPR. 2.6 The Partial Area Under the ROC Curve. 2.7 Likelihood Ratios. 2.8 Other ROC Curve Indices. 2.9 The Localization and Detection of Multiple Abnormalities. 2.10 Interpretation of Diagnostic Tests. 2.11 Optimal Decision Threshold on the ROC Curve. 2.12 Multiple Tests. 3. The Design of Diagnostic Accuracy Studies. 3.1 Determining the Objective of the Study. 3.2 Identifying the Target Patient Population. 3.3 Selecting a Sampling Plan for Patients. 3.3.1 Phase I: Exploratory Studies. 3.3.2 Phase II: Challenge Studies. 3.3.3 Phase III: Clinical Studies. 3.4 Selecting the Gold Standard. 3.5 Choosing a Measure of Accuracy. 3.6 Identifying the Target Reader Population. 3.7 Selecting a Sampling Plan for Readers. 3.8 Planning the Data Collection. 3.8.1 Format for the Test Results. 3.8.2 Data Collection for the Reader Studies. 3.8.3 Reader Training. 3.9 Planning the Data Analyses. 3.9.1 Statistical Hypotheses. 3.9.2 Reporting the Test Results. 3.10 Determining the Sample Size. 4. Estimation and Hypothesis Testing in a Single Sample. 4.1 Binary Scale Data. 4.1.1 Sensitivity and Specificity. 4.1.2 The Sensitivity and Specificity of Clustered Binary Data. 4.1.3 The Likelihood Ratio (LR). 4.1.4 The Odds Ratio. 4.2 Ordinal Scale Data. 4.2.1 The Empirical ROC Curve. 4.2.2 Fitting a Smooth Curve (Parametric Model). 4.2.3 Estimation of Sensitivity at a Particular FPR. 4.2.4 The Area and Partial Area Under the ROC Curve (Parametric Model). 4.2.5 The Area Under the Curve (Nonparametric Method). 4.2.6 Nonparametric Analysis of Clustered Data. 4.2.7 The Degenerate Data. 4.2.8 Choosing Between Parametric and Nonparametric Methods. 4.3 Continuous Scale Data. 4.3.1 The Empirical ROC Curve. 4.3.2 Fitting a Smooth ROC Curve (Parametric and Nonparametric Methods). 4.3.3 Area Under the ROC Curve (Parametric and Nonparametric). 4.3.4 Fixed FPR The Sensitivity and Decision Threshold. 4.3.5 Choosing the Optimal Operating Point. 4.3.6 Choosing Between Parametric and Nonparametric Techniques. 4.4 Hypothesis Testing About the ROC Area. 5. Comparing the Accuracy of Two Diagnostic Tests. 5.1 Binary Scale Data. 5.1.1 Sensitivity and Specificity. 5.1.2 Sensitivity and Specificity of Clustered Binary Data. 5.2 Ordinal and Continuous Scale Data. 5.2.1 Determining the Equality of Two ROC Curves. 5.2.2 Comparing ROC Curves at a Particular Point. 5.2.3 Determining the Range of FPR for Which TPR Differ. 5.2.4 A Comparison of the Area or Partial Area. 5.3 Tests of Equivalence. 6. Sample Size Calculation. 6.1 The Sample Size for Accuracy Studies of a Single Test. 6.1.1 Sensitivity and Specificity. 6.1.2 The Area Under the ROC Curve. 6.1.3 The Sensitivity at a Fixed FPR. 6.1.4 The Partial Area Under the ROC Curve. 6.2 The Sample Size for the Accuracy of Two Tests. 6.2.1 Sensitivity and Specificity. 6.2.2 The Area Under the ROC Curve. 6.2.3 The Sensitivity at a Fixed FPR. 6.2.4 The Partial Area Under the ROC Curve. 6.3 The Sample Size for Equivalent Studies of Two Tests. 6.4 The Sample Size for Determining a Suitable Cutoff Value. 7. Issues in Meta Analysis for Diagnostic Tests. 7.1 Objectives. 7.2 Retrieval of the Literature. 7.3 Inclusion Exclusion Criteria. 7.4 Extracting Information From the Literature. 7.5 Statistical Analysis. 7.6 Public Presentation. II ADVANCED METHODS. 8. Regression Analysis for Independent ROC Data. 8.1 Four Clinical Studies. 8.1.1 Surgical Lesion in a Carotid Vessel Example. 8.1.2 Pancreatic Cancer Exampl. 8.1.3 Adult Obesity Example. 8.1.4 Staging of Prostate Cancer Example. 8.2 Regression Models for Continuous Scale Tests. 8.2.1 Indirect Regression Models for Smooth ROC Curves. 8.2.2 Direct Regression Models for Smooth ROC Curves. 8.2.3 MRA Use for Surgical Lesion Detection in the Carotid Vessel. 8.2.4 Biomarkers for the Detection of Pancreatic Cancer. 8.2.5 Prediction of Adult Obesity by Using Childhood BMI Measurements. 8.3 Regression Models for Ordinal Scale Tests. 8.3.1 Indirect Regression Models for Latent Smooth ROC Curves. 8.3.2 Direct Regression Model for Latent Smooth ROC Curves. 8.3.3 Detection of Periprostatic Invasion With US. 9. Analysis of Correlated ROC Data. 9.1 Studies With Multiple Test Measurements of the Same Patient. 9.1.1 Indirect Regression Models for Ordinal Scale Tests. 9.1.2 Neonatal Examination Example. 9.1.3 Direct Regression Models for Continuous Scale Tests. 9.2 Studies With Multiple Readers and Tests. 9.2.1 A Mixed Effects ANOVA Model for Summary Measures of Diagnostic Accuracy. 9.2.2 Detection of TAD Example. 9.2.3 The Mixed Effects ANOVA Model for Jackknife Pseudovalues. 9.2.4 Neonatal Examination Example. 9.2.5 A Bootstrap Method. 9.3 Sample Size Calculation for Multireader Studies. 10. Methods for Correcting Verification Bias. 10.1 A Single Binary Scale Test. 10.1.1 Correction Methods With the MAR Assumption. 10.1.2 Correction Methods Without the MAR Assumption. 10.1.3 Hepatic Scintigraph Example. 10.2 Correlated Binary Scale Tests. 10.2.1 An ML Approach Without Covariates. 10.2.2 An ML Approach With Covariates. 10.2.3 Screening Tests for Dementia Disorder Example. 10.3 A Single Ordinal Scale Test. 10.3.1 An ML Approach Without Covariates. 10.3.2 Fever of Uncertain Origin Example. 10.3.3 An ML Approach With Covariates. 10.3.4 Screening Test for Dementia Disorder Example. 10.4 Correlated Ordinal Scale Tests. 10.4.1 The Weighted GEE Approach for Latent Smooth ROC Curves. 10.4.2 A Likelihood Based Approach for ROC Areas. 10.4.3 Use of CT and MRI for Staging Pancreatic Cancer Example. 11. Methods for Correcting Imperfect Standard Bias. 11.1 One Single Test in a Single Population. 11.1.1 Hypothetical and Strongyloides Infection Examples. 11.2 One Single Test in G Populations. 11.2.1 Tuberculosis Example. 11.3 Multiple Tests in One Single Population. 11.3.1 MLEs Under the CIA. 11.3.2 Assessment of Pleural Thickening Example. 11.3.3 ML Approaches Without the CIA. 11.3.4 Bioassays for HIV Example. 11.4 Multiple Binary Tests in G Populations. 11.4.1 ML Approaches Under the CIA. 11.4.2 ML Approaches Without the CIA. 12. Statistical Methods for Meta Analysis. 12.1 Sensitivity and Specificity Pairs. 12.1.1 One Common SROC Curve. 12.1.2 Study Specific SROC Curve. 12.1.3 Evaluation of Duplex Ultrasonography, With and Without Color Guidance. 12.2 ROC Curve Areas. 12.2.1 Fixed Effects Models. 12.2.2 Random Effects Models. 12.2.3 Evaluation of the Dexamethasone Suppression.Test. Index.

Statistical Methods in Diagnostic Medicine

Nosocomial bloodstream infections are important causes of morbidity and mortality. In this study, concurrent surveillance for nosocomial bloodstream infections at 49 hospitals over a 3-year period detected >10,000 infections. Gram-positive organisms accounted for 64% of cases, gram-negative organisms accounted for 27%, and 8% were caused by fungi. The most common organisms were coagulase-negative staphylococci (32%), Staphylococcus aureus (16%), and enterococci (11%). Enterobacter, Serratia, coagulase-negative staphylococci, and Candida were more likely to cause infections in patients in critical care units. In patients with neutropenia, viridans streptococci were significantly more common. Coagulase-negative staphylococci were the most common pathogens on all clinical services except obstetrics, where Escherichia coli was most common. Methicillin resistance was detected in 29% of S. aureus isolates and 80% of coagulase-negative staphylococci. Vancomycin resistance in enterococci was species-dependent-3% of Enterococcus faecalis strains and 50% of Enterococcus faecium isolates displayed resistance. These data may allow clinicians to better target empirical therapy for hospital-acquired cases of bacteremia.

https://www.jstor.org/stable/pdfplus/4460866.pdf

Nosocomial Bloodstream Infections in United States Hospitals: A Three-Year Analysis

This article describes short form versions of the Incontinence Impact Questionnaire (IIQ) and the Urogenital Distress Inventory (UDI). These instruments assess life impact and symptom distress, respectively, of urinary incontinence and related conditions for women. All subsets regression analysis was used to find item subsets that best approximated scores of the long form versions. The approach succeeded in reducing the 30-item IIQ and the 19-item UDI to 7- and 6-item short forms, respectively. The short form versions may be more useful than the long form versions in many clinical and research applications.

Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group.

Urinary incontinence (UI) is a relatively common condition in middle-aged and older women Traditional measures of symptoms do not adequately capture the impact that UI has on individuals' lives Further, severe morbidity and mortality are not associated with this condition Rather, Ul's impact is primarily on the health status and health-related quality of life (HRQOL) of women Generic measures of HRQOL inadequately address the impact of the condition on the day-to-day lives of women with UI The current paper presents data on two new condition-specific instruments designed to assess the HRQOL of UI in women: the Urogenital Distress Inventory (UDI) and the Incontinence Impact Questionaire (IIQ) Used in conjunction with one another, these two measures provide detailed information on how UI affects the lives of women The measures provide data on the more traditional view of HRQOL by assessing the impact of UI on various activities, roles and emotional states (IIQ), as well as data on the less traditional but critical issue of the degree to which symptoms associated with UI are troubling to women (UDI) Data on the reliability, validity and sensitivity to change of these measures demonstrate that they are psychometrically strong Further, they have been developed for simple, self-administration

Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program in Women (CPW) Research Group.

Donna K. McClish

Papers

Statistical Methods for Meta‐Analysis

Statistical Methods in Diagnostic Medicine

Nosocomial Bloodstream Infections in United States Hospitals: A Three-Year Analysis

Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group.

Health-related quality of life measures for women with urinary incontinence: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program in Women (CPW) Research Group.