Dissemination in diagnostic accuracy studies is not associated with methodological quality: a systematic review and meta-epidemiological analysis
type: Article
item type: journalArticle
is part of: J Clin Epidemiol
authors: Person
  surname: Nilius
  given name: H.
authors: Person
  surname: Kuster
  given name: L.
authors: Person
  surname: Boss
  given name: R.
authors: Person
  surname: Boschetti
  given name: L.
authors: Person
  surname: Mihalek
  given name: N.
authors: Person
  surname: Soares Ferreira Junior
  given name: A.
authors: Person
  surname: Naas
  given name: S.
authors: Person
  surname: Jegerlehner
  given name: S.
authors: Person
  surname: Largiader
  given name: C. R.
authors: Person
  surname: Nakas
  given name: C.
authors: Person
  surname: Nagler
  given name: M.
subject: Diagnostic tests
subject: Dissemination
subject: Impact of studies
subject: Journal impact factor
subject: Methods
subject: Publication bias
subject: Publication success
subject: Routine
subject: Science of science
abstract: OBJECTIVES: 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 assessed methodological quality and support strengthening diagnostic-specific approaches to evidence appraisal. PLAIN LANGUAGE SUMMARY: We examined whether high-quality diagnostic studies receive more attention in science and clinical practice. Using a large set of studies on COVID-19 antibody tests, we found that atten…
date: 2026-04-20
pages: 112270
coverage: 42001977

J Clin Epidemiol
type: Journal
volume: 195
alternative: J Clin Epidemiol
identifier: DOI 10.1016/j.jclinepi.2026.112270
identifier: ISSN 1878-5921 (Electronic)