Interpreting and assessing confidence in network meta-analysis results: an introduction for clinicians

Abstract

Purpose We aimed to provide clinicians with introductory guidance for interpreting and assessing confidence in on Network meta-analysis (NMA) results. Methods We reviewed current literature on NMA and summarized key points. Results Network meta-analysis (NMA) is a statistical method for comparing the efficacy of three or more interventions simultaneously in a single analysis by synthesizing both direct and indirect evidence across a network of randomized clinical trials. It has become increasingly popular in healthcare, since direct evidence (head-to-head randomized clinical trials) are not always available. NMA methods are categorized as either Bayesian or frequentist, and while the two mostly provide similar results, the two approaches are theoretically different and require different interpretations of the results. Conclusions We recommend a careful approach to interpreting NMA results and the validity of an NMA depends on its underlying statistical assumptions and the quality of the evidence used in the NMA.

Comparative efficacy and safety of bimekizumab in axial spondyloarthritis: a systematic literature review and network meta-analysis

“…Overall, the included RCTs had a low risk of bias, with some elements of the assessment ranking unclear due to missing reporting. One area of weakness was that a small number of baseline characteristics differed across the randomized treatment groups within five AS trials and one nr-axSpA trial [ 47 , 62–66 ]. However, no studies were deemed unsuitable for inclusion in the NMA based on concerns regarding risk of bias.…”

A guide to appropriately planning and conducting meta-analyses: part 3. Special considerations—the network meta-analysis

“…The output of network meta‐analyses may consist of odds ratios or mean differences with 95% confidence intervals for the pairwise interactions [19]. These can be represented using tabular formatting, forest plots using one intervention as a reference, and network diagrams.…”

Comparative effectiveness of non-pharmacological interventions for primary dysmenorrhea: A protocol for a systematic review and network meta-analysis

“…Network meta-analysis (NMA) is an analytical method that simultaneously estimates the relative efficacy of multiple treatments by gathering direct and indirect evidence. 30 To the best of our knowledge, no NMA has proven which non-pharmacological intervention is best for PD. Therefore, we propose this systematic review and NMA protocol to compare and rank the short-term and long-term analgesic effects of non-pharmacological interventions in patients with PD.…”