We did not consider systematic reviews that did not use quantitative analysis methods because one of our key aims was to assess the temporal evolution and current status of meta-analytic methods for synthesizing test accuracy data.
We only included English-language reviews published in full text retrieving the full-text and extracting information from non-English articles entails substantial effort and would be unlikely to affect our conclusions.
Our definition of tests encompassed clinical signs and symptoms. Papers were considered eligible when they reported the findings of systematic reviews (defined as reviews using explicit methods to identify, select and extract information from primary research studies) that used quantitative synthesis (meta-analysis) methods to obtain summary estimates of diagnostic or predictive accuracy of medical tests. The complete search strategy is presented in Appendix A. All rights reserved.We searched the MEDLINE database (1966 through to December 2009) using a combination of key words related to test accuracy and meta-analysis. More studies in other settings (for example, in primary care) are necessary.Īccuracy studies Bipolar disorder Meta-analysis Screening Systematic review.Ĭopyright © 2014 Elsevier B.V. Several included studies had a high risk of bias.Īlthough accuracy properties of the three screening instruments did not consistently differ in mental health care services, the HCL-32 was more accurate than the MDQ for the detection of type II BD. Most studies were performed in mental health care settings. At a cutoff of 7, the MDQ had a summary sensitivity of 43% and a summary specificity of 95% for detection of bipolar disorder in primary care or general population settings. The HCL-32 was more accurate than the MDQ for the detection of type II bipolar disorder in mental health care centers (P=0.018). At recommended cutoffs, summary sensitivities were 81%, 66% and 69%, while specificities were 67%, 79% and 86% for the HCL-32, MDQ, and BSDS in psychiatric services, respectively. The QUADAS-2 tool was used to rate bias.įifty three original studies met inclusion criteria (N=21,542). Studies were included if the accuracy properties of the screening measures were determined against a DSM or ICD-10 structured diagnostic interview. The Pubmed, EMBASE, Cochrane, PsycINFO and SCOPUS databases were searched. A systematic review and meta-analysis of accuracy studies for the bipolar spectrum diagnostic scale (BSDS), the hypomania checklist (HCL-32) and the mood disorder questionnaire (MDQ) were performed. Several influential publications recommend the routine screening of bipolar disorder. 9 Bipolar Disorders Unit, Clinical Institute of Neurosciences, Hospital Clinic, IDIBAPS, University of Barcelona, CIBERSAM, Barcelona, Catalonia, Spain.īipolar spectrum disorders are frequently under-recognized and/or misdiagnosed in various settings.8 Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, ON, Canada Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada.
7 Department of Psychiatry, University of Ioaninna, Ioaninna, Greece.6 Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, SC, Brazil Center for Experimental Models in Psychiatry, Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, Houston, TX, USA.5 Memory Research Laboratory, Brain Institute (ICe), Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil.4 Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, ON, Canada.3 (a)Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil.Electronic address: 2 Department of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK. 1 (a)Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil.