Progress and challenges of network meta‐analysis

Tian, Jinhui; Gao, Ya; Zhang, Junhua; Yang, Zhirong; Dong, Shengjie; Zhang, Tiansong; Sun, Feng; Wu, Shanshan; Wu, Jiarui; Wang, Junfeng; Yao, Liang; Ge, Long; Li, Lun; Shi, Chunhu; Wang, Quan; Jiang, Li; Zhao, Ye; Xiao, Yifei; Fu, Yang; Fan, Jinchun; Bao, Shisan

doi:10.1111/jebm.12443

Cited by 19 publications

(15 citation statements)

References 130 publications

(280 reference statements)

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“…Such conflicting results make it challenging for clinicians to accurately provide prognostic data for patients in this area. Comparison of several autograft choices simultaneously, possible through a network analysis [39], would allow for inference regarding the relative effect of these treatments as it pertains to donor site morbidity. Furthermore, this approach may prove valuable by allowing comparisons of interventions that may not have been directly compared in head‐to‐head trials and providing clarity as it pertains to the conflicting results observed with prior direct comparisons.…”

Section: Introductionmentioning

confidence: 99%

Lower donor site morbidity with hamstring and quadriceps tendon autograft compared with bone-patellar tendon-bone autograft after anterior cruciate ligament reconstruction: a systematic review and network meta-analysis of randomized controlled trials

Kunze

Moran

Polce

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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PurposeTo perform a meta‐analysis of RCTs evaluating donor site morbidity after bone–patellar tendon–bone (BTB), hamstring tendon (HT) and quadriceps tendon (QT) autograft harvest for anterior cruciate ligament reconstruction (ACLR). MethodsPubMed, OVID/Medline and Cochrane databases were queried in July 2022. All level one articles reporting the frequency of specific donor‐site morbidity were included. Frequentist model network meta‐analyses with P‐scores were conducted to compare the prevalence of donor‐site morbidity, complications, all‐cause reoperations and revision ACLR among the three treatment groups. ResultsTwenty‐one RCTs comprising the outcomes of 1726 patients were included. The overall pooled rate of donor‐site morbidity (defined as anterior knee pain, difficulty/impossibility kneeling, or combination) was 47.3% (range, 3.8–86.7%). A 69% (95% confidence interval [95% CI]: 0.18–0.56) and 88% (95% CI: 0.04–0.33) lower odds of incurring donor‐site morbidity was observed with HT and QT autografts, respectively (p < 0.0001, both), when compared to BTB autograft. QT autograft was associated with a non‐statistically significant reduction in donor‐site morbidity compared with HT autograft (OR: 0.37, 95% CI: 0.14–1.03, n.s.). Treatment rankings (ordered from best‐to‐worst autograft choice with respect to donor‐site morbidity) were as follows: (1) QT (P‐score = 0.99), (2) HT (P‐score = 0.51) and (3) BTB (P‐score = 0.00). No statistically significant associations were observed between autograft and complications (n.s.), reoperations (n.s.) or revision ACLR (n.s.). ConclusionACLR using HT and QT autograft tissue was associated with a significant reduction in donor‐site morbidity compared to BTB autograft. Autograft selection was not associated with complications, all‐cause reoperations, or revision ACLR. Based on the current data, there is sufficient evidence to recommend that autograft selection should be personalized through considering differential rates of donor‐site morbidity in the context of patient expectations and activity level without concern for a clinically important change in the rate of adverse events. Level of evidenceLevel I.

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Section: Introductionmentioning

confidence: 99%

Lower donor site morbidity with hamstring and quadriceps tendon autograft compared with bone-patellar tendon-bone autograft after anterior cruciate ligament reconstruction: a systematic review and network meta-analysis of randomized controlled trials

Kunze

Moran

Polce

et al. 2023

Knee Surg Sports Traumatol Arthrosc

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“…The recent growth of network meta-analysis (NMA) has revolutionized outcomes research and our abilities to compare treatments to improve patient outcomes. 1 Despite this innovation, most evidence synthesis of health service interventions (HSI) have focused on exploring the effect of interventions rather than how to deliver such interventions. 2 To fill this gap, a framework classifying delivery by Theme (T), Intensity (I), and Provider/Platform (P) (TIP framework) was developed.…”

Section: The Potential Benefits Of the Tip Framework To Characterize ...mentioning

confidence: 99%

The potential benefits of the TIP framework to characterize health services interventions for network meta‐analysis

Cooksey

Veettil

Chaiyakunapruk

et al. 2023

J Evidence Based Medicine

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“…Furthermore, it avoids the inflation of type I errors (multiplicity) introduced by performing a series of head-to-head comparisons. [23]…”

Section: Comparative Studiesmentioning

confidence: 99%

Methods for meta-analysis and meta-regression of proportions: concepts and tutorial with Stata command metapreg

Nyaga

Arbyn

2022

Preprint

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Background: Despite the widespread use of meta-analysis of proportions, its rationale, certain theoretical and methodological concepts are poorly understood.The framework of logistic regression is well-established and provides a natural and optimal model for meta-analysis, network meta-analysis, and meta-regressionof proportions. Nonetheless, classical tools for meta-analysis of proportions based on approximation to the normal distribution continue to dominate. Methods: We explain the rationale and concepts essential in understanding statistical methods for meta-analysis of proportions. We then present metapreg; a flexible model-based tool with advanced statistical procedures to perform ameta-analysis, network meta-analysis, and meta-regression of proportions in Stata. The tool implements the logistic and the logistic-normal regression, andmarginal standardization to yield population-averaged estimates. Finally, we demonstrate using metapreg with data from four published meta-analyses; a)cure rate of treatment for cervical pre-cancer using cold coagulation, b)incomplete excision of cervical precancer as a predictor of treatment failure, c)effect of geographical area on the protective effect of BCG vaccination againsttuberculosis and d) response rate to treatment of acute mania in adults withdiverse drugs. Conclusion: metapreg is an efficient and user-friendly statistical tool dedicatedt o meta-analysis, network meta-analysis and meta-regression of binomial data. It allows both continuous and categorical explanatory covariates including relevant interactions to explain the variability in the proportions.

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Progress and challenges of network meta‐analysis

Cited by 19 publications

References 130 publications

Lower donor site morbidity with hamstring and quadriceps tendon autograft compared with bone-patellar tendon-bone autograft after anterior cruciate ligament reconstruction: a systematic review and network meta-analysis of randomized controlled trials

Lower donor site morbidity with hamstring and quadriceps tendon autograft compared with bone-patellar tendon-bone autograft after anterior cruciate ligament reconstruction: a systematic review and network meta-analysis of randomized controlled trials

The potential benefits of the TIP framework to characterize health services interventions for network meta‐analysis

Methods for meta-analysis and meta-regression of proportions: concepts and tutorial with Stata command metapreg

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