Network meta-analysis: a technique to gather evidence from direct and indirect comparisons
Pharm. pract. (Granada, Internet)
; 15(1): 0-0, ene.-mar. 2017. tab, ilus, graf
Article
in English
| IBECS
| ID: ibc-161867
Responsible library:
ES1.1
Localization: BNCS
ABSTRACT
Systematic reviews and pairwise meta-analyses of randomized controlled trials, at the intersection of clinical medicine, epidemiology and statistics, are positioned at the top of evidence-based practice hierarchy. These are important tools to base drugs approval, clinical protocols and guidelines formulation and for decision-making. However, this traditional technique only partially yield information that clinicians, patients and policy-makers need to make informed decisions, since it usually compares only two interventions at the time. In the market, regardless the clinical condition under evaluation, usually many interventions are available and few of them have been studied in head-to-head studies. This scenario precludes conclusions to be drawn from comparisons of all interventions profile (e.g. efficacy and safety). The recent development and introduction of a new technique - usually referred as network meta-analysis, indirect meta-analysis, multiple or mixed treatment comparisons - has allowed the estimation of metrics for all possible comparisons in the same model, simultaneously gathering direct and indirect evidence. Over the last years this statistical tool has matured as technique with models available for all types of raw data, producing different pooled effect measures, using both Frequentist and Bayesian frameworks, with different software packages. However, the conduction, report and interpretation of network meta-analysis still poses multiple challenges that should be carefully considered, especially because this technique inherits all assumptions from pairwise meta-analysis but with increased complexity. Thus, we aim to provide a basic explanation of network meta-analysis conduction, highlighting its risks and benefits for evidence-based practice, including information on statistical methods evolution, assumptions and steps for performing the analysis (AU)
RESUMEN
No disponible
Full text:
Available
Collection:
National databases
/
Spain
Health context:
Sustainable Health Agenda for the Americas
Health problem:
Goal 7: Evidence and knowledge in health
Database:
IBECS
Main subject:
Meta-Analysis as Topic
/
Decision Support Techniques
/
Treatment Outcome
/
Evidence-Based Medicine
Type of study:
Controlled clinical trial
/
Practice guideline
/
Prognostic study
/
Systematic review
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Pharm. pract. (Granada, Internet)
Year:
2017
Document type:
Article
Institution/Affiliation country:
Federal University of Paraná/Brazil
/
Hospital de Clínicas/Brazil