Imaging research Improving the quality of systematic reviews and diagnostic test accuracy studies

This thesis’ objective was to address issues in: A) Imaging diagnostic accuracy research; B) Imaging diagnostic accuracy systematic reviews and C) Imaging meta-research in the form of evaluation of reporting and methods. This first section focuses on primary diagnostic accuracy research in imaging. Chapter 2 describes an evaluation of the use of CT for evaluation of internal hernia in the cohort of patients who have had laparoscopic Roux-en-Y gastric bypass surgery using surgery and long term clinical follow up as a reference standard. Chapter 3 describes an evaluation of the diagnostic accuracy of quantitative CT texture analysis to differentiate fat-poor renal angiomyolipoma from renal cell carcinoma on unenhanced CT.
The second section presents examples of systematic review and meta-analysis of imaging research. Chapter 4 is a systematic review of Accuracy of Gadoxetic Acid-enhanced MRI Imaging for Focal Nodular Hyperplasia vs. Hepatocellular Adenoma. Chapter 5 is a systematic review evaluating the complication rate and diagnostic accuracy of image-guided biopsy of the spleen.
This third section documents meta-research and guidance on imaging diagnostic accuracy primary research and systematic reviews. Chapter 6 evaluates quality and completeness of reporting of imaging systematic reviews. Chapter 7 evaluates techniques used for meta-analyses in imaging diagnostic accuracy systematic reviews and their effect on summary estimates of diagnostic accuracy. Chapter 8 is a guidance paper on common pitfalls for systematic reviews in imaging research. Chapter 9 evaluates adherence of imaging diagnostic accuracy studies to STARD 2015. Chapter 10 describes persistent deficiencies and new questions raised by our work.