Multivariate and network meta-analysis of multiple outcomes and multiple treatments: rationale, concepts, and examples

Abstract

Organisations such as the National Institute for Health and Care Excellence require the synthesis of evidence from existing studies to inform their decisions—for example, about the best available treatments with respect to multiple efficacy and safety outcomes. However, relevant studies may not provide direct evidence about all the treatments or outcomes of interest. Multivariate and network meta-analysis methods provide a framework to address this, using correlated or indirect evidence from such studies alongside any direct evidence. In this article, the authors describe the key concepts and assumptions of these methods, outline how correlated and indirect evidence arises, and illustrate the contribution of such evidence in real clinical examples involving multiple outcomes and multiple treatments

Comparative efficacy of antiepileptic drugs in children and adolescents: A network meta‐analysis

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Observational research on sodium glucose co‐transporter‐2 inhibitors: A real breakthrough?

“…This systematic review with an NMA has several strengths and followed current standards for reporting and conducting meta‐analytical studies 75, 76. However, clinicians should be advised that focusing on the probability of being ranked first is potentially misleading.…”

Antiepileptic monotherapy in newly diagnosed focal epilepsy. A network meta-analysis

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