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Network meta-analysis: users guide for pediatricians
#MMPMID29843665
Al Khalifah R
; Florez ID
; Guyatt G
; Thabane L
BMC Pediatr
2018[May]; 18
(1
): 180
PMID29843665
show ga
BACKGROUND: Network meta-analysis (NMA) is a powerful analytic tool that allows
simultaneous comparison between several management/treatment alternatives even
when direct comparisons of the alternatives (such as the case in which treatments
are compared against placebo and have not been compared against each other) are
unavailable. Though there are still a limited number of pediatric NMAs published,
the rapid increase in NMAs in other areas suggests pediatricians will soon be
frequently facing this new form of evidence summary. DISCUSSION: Evaluating the
NMA evidence requires serial judgments on the creditability of the process of NMA
conduct, and evidence quality assessment. First clinicians need to evaluate the
basic standards applicable to any meta-analysis (e.g. comprehensive search,
duplicate assessment of eligibility, risk of bias, and data abstraction). Then
evaluate specific issues related to NMA including precision, transitivity,
coherence, and rankings. CONCLUSIONS: In this article we discuss how clinicians
can evaluate the credibility of NMA methods, and how they can make judgments
regarding the quality (certainty) of the evidence. We illustrate the concepts
using recent pediatric NMA publications.
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