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Bayesian Approaches to Meta-analysi of ROC Curves

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  • Martin Hellmich
  • Keith R. Abrams
  • Alex J. Sutton

Abstract

A comparative review of important classic and Bayesian approaches to fixed-effects and random-effects meta-analysis of binormal ROC curves and areas underneath them is presented. The ROC analyses results of seven evaluation studies concerning the dexamethasone suppression test provide the basis for a worked example. Particular attention is given to fully Bayesian inference, a novelty in the ROC context, based on Gibbs samples from posterior distributions of hierarchical model parameters and re lated quantities. Fully Bayesian meta-analysis may properly account for the uncertainty associated with the model parameters, possibly incorporating prior knowledge and beliefs, and allows clinically intuitive predictions of unobserved study effects via cal culation of posterior predictive densities. The effects of various different prior specifi cations (six noninformative as well as one informative) on the posterior estimates are investigated (sensitivity-analysis). Recommendations and suggestions for further re search are made. Computer code for the more advanced methods may either be downloaded via the Internet or be found elsewhere. Key words : Bayesian methods; random effects; meta-analysis; ROC curve; diagnostic test; hierarchical models; Mar kov-chain Monte Carlo technique; Gibbs sampling; maximum likelihood; method of moments. (Med Decis Making 1999; 19:252-264)

Suggested Citation

  • Martin Hellmich & Keith R. Abrams & Alex J. Sutton, 1999. "Bayesian Approaches to Meta-analysi of ROC Curves," Medical Decision Making, , vol. 19(3), pages 252-264, August.
    • Handle: RePEc:sae:medema:v:19:y:1999:i:3:p:252-264
    DOI: 10.1177/0272989X9901900304
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    References listed on IDEAS

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    1. Fengchun Peng & W.Jack Hall, 1996. "Bayesian Analysis of ROC Curves Using Markov-chain Monte Carlo Methods," Medical Decision Making, , vol. 16(4), pages 404-411, October.
    2. Martin Hellmich & Keith R. Abrams & David R. Jones & Paul C. Lambert, 1998. "A Bayesian Approach to a General Regression Model for ROC Curves," Medical Decision Making, , vol. 18(4), pages 436-443, October.
    3. Vic Hasselblad & Douglas C. McCrory, 1995. "Meta-analytic Tools for Medical Decision Making: A Practical Guide," Medical Decision Making, , vol. 15(1), pages 81-96, February.
    4. David M. Eddy & Vic Hasselblad & Ross Shachter, 1990. "An Introduction to a Bayesian Method for Meta-analysis," Medical Decision Making, , vol. 10(1), pages 15-23, February.
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