Evaluation of the methodological quality of studies of the performance of diagnostic tests for bovine tuberculosis using QUADAS

Sara H. Downs*, Simon J. More, Anthony V. Goodchild, Adam O. Whelan, Darrell A. Abernethy, Jennifer M. Broughan, Angus Cameron, Alasdair J. Cook, R. Ricardo de la Rua-Domenech, Matthias Greiner, Jane Gunn, Javier Nuñez-Garcia, Shelley Rhodes, Simon Rolfe, Michael Sharp, Paul Upton, Eamon Watson, Michael Welsh, John A. Woolliams, Richard S. Clifton-HadleyJessica E. Parry

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)
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There has been little assessment of the methodological quality of studies measuring the performance (sensitivity and/or specificity) of diagnostic tests for animal diseases. In a systematic review, 190 studies of tests for bovine tuberculosis (bTB) in cattle (published 1934–2009) were assessed by at least one of 18 reviewers using the QUADAS (Quality Assessment of Diagnostic Accuracy Studies) checklist adapted for animal disease tests. VETQUADAS (VQ) included items measuring clarity in reporting (n = 3), internal validity (n = 9) and external validity (n = 2). A similar pattern for compliance was observed in studies of different diagnostic test types. Compliance significantly improved with year of publication for all items measuring clarity in reporting and external validity but only improved in four of the nine items measuring internal validity (p < 0.05). 107 references, of which 83 had performance data eligible for inclusion in a meta-analysis were reviewed by two reviewers. In these references, agreement between reviewers’ responses was 71% for compliance, 32% for unsure and 29% for non-compliance. Mean compliance with reporting items was 2, 5.2 for internal validity and 1.5 for external validity. The index test result was described in sufficient detail in 80.1% of studies and was interpreted without knowledge of the reference standard test result in only 33.1%. Loss to follow-up was adequately explained in only 31.1% of studies. The prevalence of deficiencies observed may be due to inadequate reporting but may also reflect lack of attention to methodological issues that could bias the results of diagnostic test performance estimates. QUADAS was a useful tool for assessing and comparing the quality of studies measuring the performance of diagnostic tests but might be improved further by including explicit assessment of population sampling strategy.

Original languageEnglish
Pages (from-to)108-116
Number of pages9
JournalPreventive Veterinary Medicine
Early online date22 Mar 2017
Publication statusPublished - 01 May 2018


  • Bovine tuberculosis
  • Diagnostic tests
  • Evaluation
  • External validity
  • Internal validity
  • Quality


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