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Open Access Highly Accessed Correspondence

Graphical presentation of diagnostic information

Penny F Whiting1*, Jonathan AC Sterne1, Marie E Westwood2, Lucas M Bachmann3, Roger Harbord1, Matthias Egger4 and Jonathan J Deeks5

Author Affiliations

1 Department of Social Medicine, Canynge Hall, Whiteladies Road, Bristol, BS8 2PR, UK

2 Centre for Reviews and Dissemination, University of York, YO10 5DD, UK

3 Horten Centre, Zürich, Switzerland

4 Department of Social and Preventive Medicine, University of Bern, Switzerland

5 Medical Statistics Group/Diagnostic Research Group, Department of Public Health and Epidemiology, University of Birmingham, B15 2TT, UK

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BMC Medical Research Methodology 2008, 8:20  doi:10.1186/1471-2288-8-20

Published: 11 April 2008

Abstract

Background

Graphical displays of results allow researchers to summarise and communicate the key findings of their study. Diagnostic information should be presented in an easily interpretable way, which conveys both test characteristics (diagnostic accuracy) and the potential for use in clinical practice (predictive value).

Methods

We discuss the types of graphical display commonly encountered in primary diagnostic accuracy studies and systematic reviews of such studies, and systematically review the use of graphical displays in recent diagnostic primary studies and systematic reviews.

Results

We identified 57 primary studies and 49 systematic reviews. Fifty-six percent of primary studies and 53% of systematic reviews used graphical displays to present results. Dot-plot or box-and- whisker plots were the most commonly used graph in primary studies and were included in 22 (39%) studies. ROC plots were the most common type of plot included in systematic reviews and were included in 22 (45%) reviews. One primary study and five systematic reviews included a probability-modifying plot.

Conclusion

Graphical displays are currently underused in primary diagnostic accuracy studies and systematic reviews of such studies. Diagnostic accuracy studies need to include multiple types of graphic in order to provide both a detailed overview of the results (diagnostic accuracy) and to communicate information that can be used to inform clinical practice (predictive value). Work is required to improve graphical displays, to better communicate the utility of a test in clinical practice and the implications of test results for individual patients.