Mapping the characteristics of network meta-analyses on drug therapy: A systematic review

Abstract

BackgroundNetwork meta-analysis (NMA) is a new tool developed to overcome some limitations of pairwise meta-analyses. NMAs provide evidence on more than two comparators simultaneously. This study aimed to map the characteristics of the published NMAs on drug therapy comparisons.MethodsA systematic review of NMAs comparing pharmacological interventions was performed. Searches in Medline (PubMed) and Scopus along with manual searches were conducted. The main characteristics of NMAs were systematically collected: publication metadata, criteria for drug inclusion, statistical methods used, and elements reported. A methodological quality score with 25 key elements was created and applied to the included NMAs. To identify potential trends, the median of the publication year distribution was used as a cut-off.ResultsThe study identified 365 NMAs published from 2003 to 2016 in more than 30 countries. Randomised controlled trials were the primary source of data, with only 5% including observational studies, and 230 NMAs used a placebo as a comparator. Less than 15% of NMAs were registered in PROSPERO or a similar system. One third of studies followed PRISMA and less than 9% Cochrane recommendations. Around 30% presented full-search strategies of the systematic review, and 146 NMAs stated the selection criteria for drug inclusion. Over 75% of NMAs presented network plots, but only half described their geometry. Statistical parameters (model fit, inconsistency, convergence) were properly reported by one third of NMAs. Although 216 studies exhibited supplemental material, no data set of primary studies was available. The methodological quality score (mean 13·9; SD 3·8) presented a slightly positive trend over the years.ConclusionThe map of the published NMAs emphasises the potential of this tool to gather evidence in healthcare, but it also identified some weaknesses, especially in the report, which limits its transparency and reproducibility.

Practitioner Review: Pharmacological treatment of attention‐deficit/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta‐analysis

“…Core outcome sets that include measures that track functional impact (e.g., adaptive, executive functioning) are needed to compare results across studies and the impact of treatment on functional outcome (McConachie et al, 2015). As further trials become available (which are needed across more pharmacological agents, e.g., amphetamines), network meta‐analysis may help to guide clinical decision‐making by providing comparisons of different interventions that have not been previously studied using head‐to‐head comparison trials (Cortese et al, 2018; Tonin et al, 2018).…”

Model-based Meta-analysis to Compare Primary Efficacy-endpoint, Efficacy-time Course, Safety, and Tolerability of Opioids Used in the Management of Osteoarthritic Pain in Humans

“…In general, there are three types of meta-analysis: (i) pairwise meta-analysis (PW-MA), (ii) network metaanalysis (NMA), (iii) model-based meta-analysis (MBMA). PW-MA is a method that uses a direct (head-to-head) comparison to compare the same interventions [39]. During the recent years, NMA has been used to compare the relative efficacy and safety between treatments.…”

Lag times in the publication of network meta-analyses: a survey

“…5 Over the past years, NMAs have become more widely used, increasing from fewer than 15 NMAs published per year from 2003 to 2008 to approximately 150 NMAs annually after 2014. 6 However, although high-quality NMAs can produce a broader body of evidence, this technique is resource intensive and time consuming. 7 8 Previous studies have demonstrated that the time between the last systematic search performed by the authors of a systematic review with conventional meta-analysis and the publication of their research is usually greater than 1 year.…”

“… 5 Over the past years, NMAs have become more widely used, increasing from fewer than 15 NMAs published per year from 2003 to 2008 to approximately 150 NMAs annually after 2014. 6 However, although high-quality NMAs can produce a broader body of evidence, this technique is resource intensive and time consuming. 7 8 …”