sensitivity; specificity.
author:
- 'Aristidis K. Nikoloulopoulos [^1]'
title: |
    An one-factor copula mixed model for joint meta-analysis\
    of multiple diagnostic tests
---

Introduction
============

The identification of the most accurate diagnostic test for a particular disease contributes to the prevention of unnecessary risks to patients and healthcare costs. Diagnostic test accuracy studies aim to identify a new diagnostic test that is as or more accurate than the current gold standard, yet less expensive or invasive.

Clinical and policy decisions are usually made on the basis of the results from many diagnostic test accuracy studies on the same research question. The considerable large number of diagnostic test accuracy studies has led to the use of meta-analysis. The purpose of a meta-analysis of diagnostic test accuracy studies is to combine information over different studies, and provide an integrated analysis that will have more statistical power to detect an accurate diagnostic test than an analysis based on a single study. As the accuracy of a diagnostic test is commonly measured by a pair of indices such as sensitivity and specificity, synthesis of diagnostic test accuracy studies is the most common medical application of multivariate meta-analysis (e.g., @noma-etal-2020-biometrics). Most of the existing literature 