Dissemination in diagnostic accuracy studies is not associated with methodological quality: a systematic review and meta-epidemiological analysis.
Publisher DOI
PubMed ID
42001977
Abstract
Objective
To evaluate associations between methodological characteristics and dissemination measures in diagnostic accuracy studies. The COVID-19 pandemic generated a large body of studies addressing a single diagnostic question, allowing assessment of how study characteristics relate to dissemination.
Study Design And Setting
Using a preregistered systematic review (PROSPERO CRD42023343656), we identified studies evaluating the diagnostic performance of SARS-CoV-2 serological tests through MEDLINE, EMBASE, and the iSearch Portfolio. Risk of bias and applicability were assessed using QUADAS-2. Study characteristics were linked to dissemination measures, including journal impact factor, citation counts, network-based scientific influence (PageRank), and policy and guideline citations, using multivariable regression models.
Results
Among 18,092 screened records, 782 studies met the inclusion criteria. QUADAS-2 assessments varied substantially, with 772 of 782 studies (98.7%) exhibiting high or unclear risk of bias in at least one domain. Dissemination measures were positively associated with journal impact factor, earlier publication year, reporting of extreme diagnostic accuracy estimates, and higher last-author H-index. In contrast, the number of domains rated as low risk of bias or high applicability was not positively associated with citation counts, network-based scientific influence, or policy citations.
Conclusion
Dissemination was primarily associated with structural and authorship characteristics rather than QUADAS-2 ratings. These findings suggest that dissemination in diagnostic research is more closely linked to structural factors than to assessed methodological quality and support strengthening diagnostic-specific approaches to evidence appraisal.
To evaluate associations between methodological characteristics and dissemination measures in diagnostic accuracy studies. The COVID-19 pandemic generated a large body of studies addressing a single diagnostic question, allowing assessment of how study characteristics relate to dissemination.
Study Design And Setting
Using a preregistered systematic review (PROSPERO CRD42023343656), we identified studies evaluating the diagnostic performance of SARS-CoV-2 serological tests through MEDLINE, EMBASE, and the iSearch Portfolio. Risk of bias and applicability were assessed using QUADAS-2. Study characteristics were linked to dissemination measures, including journal impact factor, citation counts, network-based scientific influence (PageRank), and policy and guideline citations, using multivariable regression models.
Results
Among 18,092 screened records, 782 studies met the inclusion criteria. QUADAS-2 assessments varied substantially, with 772 of 782 studies (98.7%) exhibiting high or unclear risk of bias in at least one domain. Dissemination measures were positively associated with journal impact factor, earlier publication year, reporting of extreme diagnostic accuracy estimates, and higher last-author H-index. In contrast, the number of domains rated as low risk of bias or high applicability was not positively associated with citation counts, network-based scientific influence, or policy citations.
Conclusion
Dissemination was primarily associated with structural and authorship characteristics rather than QUADAS-2 ratings. These findings suggest that dissemination in diagnostic research is more closely linked to structural factors than to assessed methodological quality and support strengthening diagnostic-specific approaches to evidence appraisal.
Date Issued
2026-07
Publication Type
Article
Subject(s)
Subjects
Dissemination
•
diagnostic tests
•
impact of studies
•
journal impact factor
•
methods
•
publication bias
•
publication success
•
routine
•
science of science
Language(s)
en
Author(s)
Kuster, Lukas | |
Boschetti, Laura | |
Mihalek, Nora | |
Ferreira Junior, Alexandre Soares | |
Naas, Samra |
Journal
Journal of Clinical Epidemiology
Publisher
Elsevier
ISSN
1878-5921
0895-4356
Access(Rights)
open.access