Summary receiver operating characteristic curve analysis techniques in the evaluation of diagnostic tests

The number of studies in the literature using summary receiver operating characteristic (SROC) analysis of diagnostic accuracy is rising. The SROC is useful in many such meta-analyses, but is often poorly understood by clinicians, and its use can be inappropriate. The academic literature on this topic is not always easy to comprehend. Interpretation is therefore difficult. This report aims to explain the concept of SROC analysis, its advantages, disadvantages, indications, and interpretation for the cardiothoracic surgeon. We use a practical approach to show how SROC analysis can be applied to meta-analysis of diagnostic accuracy by using a contrived dataset of studies on virtual bronchoscopy in the diagnosis of airway lesions.