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DOI: 10.1148/radiol.2431051823
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Evidence-based Practice in Radiology: Steps 3 and 4—Appraise and Apply Systematic Reviews and Meta-Analyses1

Steve Halligan, MD, FRCP, FRCR and Douglas G. Altman, DSc

1 From the Department of Specialist Radiology, University College Hospital, Podium Level 2, 235 Euston Rd, London NW1 2BU, England (S.H.); and Cancer Research UK–NHS Centre for Statistics in Medicine, Wolfson College Annexe, Oxford, England (D.G.A.). Received November 15, 2005; revision requested December 21; revision received February 23, 2006; final version accepted March 10. Address correspondence to S.H. (e-mail: s.halligan{at}ucl.ac.uk).


Figure 1
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  		Figure 1: Flow chart depicts the step-by-step process for systematic review of a diagnostic imaging test.

 

Figure 2
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  		Figure 2: Chart compares the characteristics of narrative and systematic reviews.

 

Figure 3
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  		Figure 3: Potential inclusion and exclusion criteria for study selection for a systematic review of CT colonography.

 

Figure 4
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  		Figure 4: Sample forest plot of per-patient diagnostic sensitivity of CT colonography for colorectal polyps 5 mm or larger. Data are derived from 13 individual studies. {blacksquare} = point estimate of each study (area indicates relative contribution of the study to meta-analysis); horizontal line = 95 % confidence interval (95 % CI); {diamond} = overall point estimate for meta-analysis of all component studies. In this example, the overall point estimate is 0.81 (95 % confidence interval: 0.78, 0.83).

 

Figure 5
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  		Figure 5: Summary ROC curve of sensitivity versus 1 – specificity. Data are derived from seven studies of CT colonography (2).

 




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