Bayesian bivariate meta-analysis of diagnostic test studies with interpretable priors

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In a bivariate meta-analysis the number of diagnostic studies involved is often very low so that frequentist methods may result in problems. Bayesian inference is attractive as informative priors that add small amount of information can stabilise the analysis without overwhelming the data. However, Bayesian analysis is often computationally demanding and the selection of the prior for the covariance matrix of the bivariate structure is crucial with little data. The integrated nested Laplace approximations (INLA) method provides an efficient solution to the computational issues by avoiding any sampling, but the important question of priors remain. We explore the penalised complexity (PC) prior framework for specifying informative priors for the variance parameters and the correlation parameter. PC priors facilitate model interpretation and hyperparameter specification as expert knowledge can be incorporated intuitively. We conduct a simulation study to compare the properties and behaviour of differently defined PC priors to currently used priors in the field. The simulation study shows that the use of PC priors results in more precise estimates when specified in a sensible neighbourhood around the truth. To investigate the usage of PC priors in practice we reanalyse a meta-analysis using the telomerase marker for the diagnosis of bladder cancer.