Skip to content

A threshold analysis assessed the credibility of conclusions from network meta-analysis

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)68-76
Number of pages9
JournalJournal of Clinical Epidemiology
Volume80
Early online date16 Jul 2016
DOIs
StatePublished - Dec 2016

Abstract

Objective: To assess the reliability of treatment recommendations based on network meta-analysis (NMA)

Study design: We consider evidence in an NMA to be potentially biased. Taking each pair-wise contrast in turn we use a structured series of threshold analyses to ask: (a) “How large would the bias in this evidence-base have to be before it changed our decision?” and (b) “If the decision changed, what is the new recommendation?” We illustrate the method via two NMAs in which a GRADE assessment for NMAs has been implemented: weight-loss and osteoporosis.

Results. Four of the weight-loss NMA estimates were assessed as “low” and 6 as “moderate” quality by GRADE; for osteoporosis 6 were “low”, 9 “moderate” and 1 “high”. The threshold analysis suggests plausible bias in 3 of 10 estimates in the weight-loss network could have changed the treatment recommendation. For osteoporosis plausible bias in 6 of 16 estimates could change the recommendation. There was no relation between plausible bias changing a treatment recommendation and the original GRADE assessments.

Conclusions. Reliability judgements on individual NMA contrasts do not help decision makers understand whether a treatment recommendation is reliable. Threshold analysis reveals whether the final recommendation is robust against plausible degrees of bias in the data.

Research areas

  • mixed treatment comparison, comparative effectiveness, health technology assessment, GRADE, reliability, quality assessment, bias

Download statistics

No data available

Documents

Documents

  • Full-text PDF (final published version)

    Rights statement: This is the final published version of the article (version of record). It first appeared online via Elsevier at http://www.sciencedirect.com/science/article/pii/S0895435616301950. Please refer to any applicable terms of use of the publisher.

    Final published version, 297 KB, PDF-document

    License: CC BY

  • Supplementary information PDF

    Rights statement: This is the final published version of the article (version of record). It first appeared online via Elsevier at http://www.sciencedirect.com/science/article/pii/S0895435616301950. Please refer to any applicable terms of use of the publisher.

    Final published version, 369 KB, PDF-document

    License: CC BY

DOI

View research connections

Related faculties, schools or groups