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Sample size in studies on diagnostic accuracy in ophthalmology: a literature survey
  1. Frank Bochmann1,
  2. Zoe Johnson2,
  3. Augusto Azuara-Blanco2
  1. 1Department of Ophthalmology, Lucerne, Switzerland
  2. 2Department of Ophthalmology, Aberdeen, UK
  1. Correspondence to: Dr F Bochmann Department of Ophthalmology, Cantonal Hospital of Lucerne, CH-6000, Lucerne 16, Switzerland; frank.bochmann{at}


Aim: To assess the sample sizes used in studies on diagnostic accuracy in ophthalmology.

Design and sources: A survey literature published in 2005.

Methods: The frequency of reporting calculations of sample sizes and the samples’ sizes were extracted from the published literature. A manual search of five leading clinical journals in ophthalmology with the highest impact (Investigative Ophthalmology and Visual Science, Ophthalmology, Archives of Ophthalmology, American Journal of Ophthalmology and British Journal of Ophthalmology) was conducted by two independent investigators.

Results: A total of 1698 articles were identified, of which 40 studies were on diagnostic accuracy. One study reported that sample size was calculated before initiating the study. Another study reported consideration of sample size without calculation. The mean (SD) sample size of all diagnostic studies was 172.6 (218.9). The median prevalence of the target condition was 50.5%.

Conclusion: Only a few studies consider sample size in their methods. Inadequate sample sizes in diagnostic accuracy studies may result in misleading estimates of test accuracy. An improvement over the current standards on the design and reporting of diagnostic studies is warranted.

  • CONSORT, Consolidated Standards of Reporting Trials

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  • Competing interests: None.

  • Published Online First 14 February 2007