Cited by 1,600Statistical Methods in Clinical TrialsMeta-analysis and systematic reviewsMethemoglobinemia and Tumor Lysis Syndrome

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Simultaneous comparison of multiple treatments: Combining direct and indirect evidence.

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Caldwell, Deborah M, Ades, A E, Higgins, J P T·2005·BMJ

DOI 10.1136/bmj.331.7521.897PMC PMC1255806

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A randomized comparison between rasburicase and allopurinol in children with lymphoma or

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“…gamma-aminobutyric acid (GaBa) at the GaBa a receptor. in most cases, it is administered to treat disabling anxiety and insomnia [60,61]. according to this unique algorithm, NMa allows the synthesis of data from a network of Rcts and boosts the simultaneous comparison of many interventions [19,62].”
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Method
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“In the NMA, indirect evidence is added to direct evidence for gaining precision purposes [38].”
Background
Systematic Review With Network Meta-Analysis
Zhu, G., You, J., Shi, K., He, S., Wang, L., Chen, Y., Braddock, M., & Zheng, M. (2015) · Medicine · doi:10.1097/md.0000000000000379 · Cited by 12
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“When a certain type of disease has multiple treatment plans, NMA combined with the evidence of direct comparison and indirect comparison can be used to compare multiple interventions at the same time (32).”
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“This method can increase the number of studies within each comparison, thereby narrowing the width of the confidence interval (CI) of the estimate (32,33).”
Method
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Guo, Q., Lv, Z., Wang, H., Song, L., Liu, Y., Chen, H., & Zhou, C.-Y. (2021) · Journal of Hospital Infection · doi:10.1016/j.jhin.2021.09.013 · Cited by 12
NETwork Meta-analysis Of Trials of Initial Oxygen in preterm Newborns (NETMOTION): A Protocol for Systematic Review and Individual Participant Data Network Meta-Analysis of Preterm Infants <32 Weeks’ Gestation Randomized to Initial Oxygen Concentration for Resuscitation
Sotiropoulos, J. X., Oei, J. L., Schmölzer, G. M., Hunter, K. E., Williams, J. G., Webster, A. C., Vento, M., Kapadia, V., Rabi, Y., Dekker, J., et al. (2022) · Neonatology · doi:10.1159/000525127 · Cited by 12
NICE DSU Technical Support Document 6: Embedding evidence synthesis in probabilistic cost-effectiveness analysis: software choices.
Dias, S., Sutton, A. J., Welton, N. J., & Ades, A. E. (2011) · Bristol Research (University of Bristol) · Cited by 12
Self-citation
The influence of the assessment method on the incidence of visual field progression in glaucoma: a network meta‐analysis
Ernest, P. J. G., Viechtbauer, W., Schouten, J., Beckers, H. J. M., Hendrikse, F., Prins, M. H., & Webers, C. A. B. (2010) · Acta Ophthalmologica · doi:10.1111/j.1755-3768.2010.01995.x · Cited by 12
“These studies were excluded, because including them would result in selection bias (Caldwell et al. 2005).”
Background
Study design and patient characteristics and outcome in acute mania clinical trials
Tarr, G. P., Herbison, P., de la Barra, S. L., & Glue, P. (2011) · Bipolar Disorders · doi:10.1111/j.1399-5618.2011.00904.x · Cited by 12
Efficacy and safety of diclofenac in osteoarthritis: Results of a network meta-analysis of unpublished legacy studies
Guyot, P., Pandhi, S., Nixon, R. M., Iqbal, A., Chaves, R. L., & Moore, A. (2017) · Scandinavian Journal of Pain · doi:10.1016/j.sjpain.2017.03.006 · Cited by 13
Cabozantinib Versus Standard-of-Care Comparators in the Treatment of Advanced/Metastatic Renal Cell Carcinoma in Treatment-naïve Patients: a Systematic Review and Network Meta-Analysis
Schmidt, E., Lister, J., Neumann, M., Więcek, W., Fu, S., Vataire, A. L., Sostar, J., Huang, S., & Marteau, F. (2018) · Targeted Oncology · doi:10.1007/s11523-018-0559-0 · Cited by 12
“, comparing the logarithm of the HRs [15]) [48].”
BackgroundMethod
Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta‑analysis
Lu, F., Hu, E.-D., Xu, L., Hu, Y., Lu, C., Wu, J., Li, H., Chen, D., & Chen, Y. (2018) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2018.6063 · Cited by 12
“These eight treatments were compared from six RCTs by network meta-analysis (NMA), which calculates the relative effects for all treatments, including treatments that have not been compared one by one, in the evidence network in one simultaneous analysis (18).”
Comparative fertility and pregnancy outcomes after local treatment for cervical intraepithelial neoplasia and stage 1a1 cervical cancer: protocol for a systematic review and network meta-analysis from the CIRCLE group
Athanasiou, A., Veroniki, A. A., Efthimiou, O., Kalliala, I. E. J., Naci, H., Bowden, S. J., Paraskevaidi, M., Martin‐Hirsch, P. L., Bennett, P. R., Paraskevaidis, E. A., et al. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-028009 · Cited by 12
Antiviral Agents for the Prevention and Treatment of Herpes Simplex Virus Type-1 Infection in Clinical Oncology: A Network Meta-Analysis
Al-Zoobaee, F. W. A., Loo, Y. S., Veettil, S. K., Gopinath, D., Maharajan, M. K., & Menon, R. K. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238891 · Cited by 12
Efficacy and Safety of Therapies for Acute Ischemic Stroke in China: A Network Meta-Analysis of 13289 Patients from 145 Randomized Controlled Trials
Yang, B., Shi, J., Chen, X., Ma, B., & Sun, H. X. (2014) · PLoS ONE · doi:10.1371/journal.pone.0088440 · Cited by 12
“Network meta-analysis is a relatively new technique that can be used to indirectly compare the risk or benefit associated with randomly allocated treatments that have not been directly tested against each other [14].”
Method
What you don’t know can hurt you
Fox, G. A. (2015) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199672547.003.0006 · Cited by 12
A Systematic Review and Critical Appraisal of Economic Evaluations of Pharmacological Interventions for People with Bipolar Disorder
Mavranezouli, I., & Lokkerbol, J. (2016) · PharmacoEconomics · doi:10.1007/s40273-016-0473-1 · Cited by 13
“NMA is the simultaneous comparison of multiple competing treatments in a single statistical model [70].”
Background
Comparative efficacy and safety of biosimilar‐infliximab and originator‐infliximab in combination with methotrexate in patients with active rheumatoid arthritis: a meta‐analysis of randomized controlled trials
Bae, S., & Lee, Y. H. (2018) · International Journal of Rheumatic Diseases · doi:10.1111/1756-185x.13305 · Cited by 12
Behavioural therapies versus other psychological therapies for depression
Churchill, R., Caldwell, D., Moore, T. H., Davies, P., Jones, H., Lewis, G., & Hunot, V. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008696 · Cited by 11
Self-citation
A leave-one-out algorithm for contribution analysis in component network meta-analysis
Mao, Y., Shen, Y., Yang, Q., Shi, Q., & Li, S. (2025) · BMC Medical Research Methodology · doi:10.1186/s12874-025-02619-w · Cited by 13
“It enables simultaneous comparisons of three or more interventions for a medical condition through the integration of both direct evidence from clinical trials and indirect evidence from connected treat-ment networks [3, 4].”
A new approach to evaluating loop inconsistency in network meta‐analysis
Turner, R., Band, T., Morris, T. P., Fisher, D. J., Higgins, J. P. T., Carpenter, J. R., & White, I. R. (2023) · Statistics in Medicine · doi:10.1002/sim.9872 · Cited by 10
Self-citation
Treatments for painful DDwR.
Al-Moraissi, E., Al-Maweri, A. A., Al-Tairi, N., Alkhutari, A. S., Grillo, R., & Christidis, N. (2023) · International Journal of Oral & Maxillofacial Surgery · doi:10.1016/j.ijom.2023.09.006 · Cited by 8
Short-Term Outcomes Analysis Comparing Open, Lap-Assisted, Totally Laparoscopic, and Robotic Total Gastrectomy for Gastric Cancer: A Network Meta-Analysis
Manara, M., Aiolfi, A., Bonitta, G., Schlanger, D., Popa, C., Lombardo, F., Manfredini, L., Biondi, A., Bonavina, L., & Bona, D. (2024) · Cancers · doi:10.3390/cancers16193404 · Cited by 11
“Therefore, a comprehensive network analysis focusing on TG and simultaneously comparing all surgical approaches for TG is lacking [11,12].”
Background
Does Classification of Composites for Network Meta-analyses Lead to Erroneous Conclusions?
Schwendicke, F., Blunck, U., Tu, Y., & Göstemeyer, G. (2018) · Operative Dentistry · doi:10.2341/16-344-lit · Cited by 11
Comparison of infection in cemented, cementless and hybrid primary total knee arthroplasty: a network meta‐analysis and systematic review of randomized clinical trials
Onggo, J. R., Onggo, J. D., Phan, K. H., & Wilson, C. J. (2020) · ANZ Journal of Surgery · doi:10.1111/ans.16078 · Cited by 11
Relative efficacy and safety of Janus kinase inhibitors for the treatment of active psoriatic arthritis: a network meta-analysis
Lee, Y. H., & Song, G. G. (2021) · Zeitschrift für Rheumatologie · doi:10.1007/s00393-021-01119-8 · Cited by 11
Neoadjuvant and Adjuvant Treatments Compared to Concurrent Chemoradiotherapy for Patients With Locally Advanced Cervical Cancer: A Bayesian Network Meta-Analysis
Qiao, Y., Li, H., & Peng, B. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.745522 · Cited by 11
Comparative Efficacy and Safety of Biological Agents in the Treatment of Lupus Nephritis: A Network Meta-Analysis
Lee, Y. H., & Song, G. G. (2022) · Pharmacology · doi:10.1159/000527223 · Cited by 24
The Efficacy of Probiotics, Prebiotics, and Synbiotics in Patients Who Have Undergone Abdominal Operation, in Terms of Bowel Function Post-Operatively: A Network Meta-Analysis
Ioannidis, O., Chatzakis, C., Tirta, M., Anestiadou, Ε., Zapsalis, K., Symeonidis, S., Bitsianis, S., Kotidis, E. V., Pramateftakis, M. G., Mantzoros, I., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12124150 · Cited by 12
“Subsequently, a random-effects network meta-analysis was conducted to simultaneously compare the relative effectiveness of all interventions [19].”
Method
Network vs. Pairwise Meta-Analyses: A Case Study of the Impact of an Evidence-Synthesis Paradigm on Value of Information Outcomes
Zafarí, Z., Thorlund, K., FitzGerald, J. M., Marra, C. A., & Sadatsafavi, M. (2014) · PharmacoEconomics · doi:10.1007/s40273-014-0179-1 · Cited by 9
“Network meta-analysis (NMA) is the extension of PMA that allows evidence synthesis from studies that each might have compared only a subset of treatments [6].”
Cognitive behavioural therapies versus treatment as usual for depression
Hunot, V., Moore, T. H., Caldwell, D. M., Davies, P. A., Jones, H. G., Furukawa, T. A., Lewis, G., & Churchill, R. C. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008699 · Cited by 11
Self-citation
Retracted
Improving adherence in osteoporosis: a new management algorithm for the patient with osteoporosis
Baio, G., Barbagallo, M., D’Avola, G., Luccio, A. D., Tanna, G. L. D., Falaschi, P., Iolascon, G., Malavolta, N., Robbiati, F., & Ulivieri, F. M. (2011) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2011.537259 · Cited by 11
“Of note, Bayesian analyses provide a methodology for analyzing multiple treatments even when results of different head-to-head studies are conflicting [44,45].”
Background
Once-daily fluticasone furoate/vilanterol versus twice daily combination therapies in asthma–mixed treatment comparisons of clinical efficacy
Svedsäter, H., Stynes, G., Wex, J., Frith, L., Leather, D. A., Castelnuovo, E., Detry, M. A., & Berry, S. M. (2016) · Asthma Research and Practice · doi:10.1186/s40733-015-0016-0 · Cited by 11
“Although MTC are established as a useful tool for the synthesis of evidence that is suitable for use in clinical decision-making [27], to our knowledge, this is the first study to apply this methodology to data from clinical trials in asthma to investigate the relative efficacy of specific treatments.”
Method
Network Meta-Analysis of the Effectiveness of Neoadjuvant Endocrine Therapy for Postmenopausal, HR–Positive Breast Cancer
Wang, W., Liu, C., Zhou, W., Xia, T., Xie, H., & Wang, S. (2016) · Scientific Reports · doi:10.1038/srep25615 · Cited by 11
Statistical approaches to the problem of phylogenetically correlated data
Lajeunesse, M. J., & Fox, G. A. (2015) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780199672547.003.0012 · Cited by 10
A network meta-analysis on the beneficial effect of medical expulsive therapy after extracorporeal shock wave lithotripsy
Yang, T., Liao, B., Chen, Y., Li, H., He, Q., Liu, Q., & Wang, K. (2017) · Scientific Reports · doi:10.1038/s41598-017-14862-3 · Cited by 10
Preventing shivering with adjuvant low dose intrathecal meperidine: A meta-analysis of randomized controlled trials with trial sequential analysis
Lin, Y.-C., Chen, C., Liao, Y., Liao, A. H.-W., Lin, P., & Chang, C. (2017) · Scientific Reports · doi:10.1038/s41598-017-14917-5 · Cited by 12
Network meta-analysis of surgical treatment for unstable femoral intertrochanteric fractures
Wang, H.-H., Shu, W.-B., Lan, G.-H., Zhang, X., Jiang, Z., De-hong, X., Bao, X.-X., & Li, A.-B. (2018) · Oncotarget · doi:10.18632/oncotarget.24202 · Cited by 11
“Network meta-analysis(NMA) is the preferred methodology to compare multiple interventions because it can perform direct and indirect comparisons [10].”
Method
Determining optimal strategies for primary prevention of cardiovascular disease: systematic review, cost-effectiveness review and network meta-analysis protocol
Uthman, O. A., Al-Khudairy, L., Nduka, C. U., Court, R. A., Mistry, H., Meléndez‐Torres, G. J., Taylor‐Phillips, S., & Clarke, A. (2020) · Systematic Reviews · doi:10.1186/s13643-020-01366-x · Cited by 11
“We will conduct network meta-analyses [25, 26] to compare effectiveness of the different types of interventions for primary prevention of CVD.”
Method
Efficacy of adjunctive photodynamic therapy and lasers in the non-surgical periodontal treatment: A Bayesian network meta-analysis
Zhao, P., Song, X., Nie, L., Wang, Q., Zhang, P., Ding, Y., & Wang, Q. (2020) · Photodiagnosis and Photodynamic Therapy · doi:10.1016/j.pdpdt.2020.101969 · Cited by 11
Comparative study of the efficacy and safety of tofacitinib, baricitinib, upadacitinib, and filgotinib versus methotrexate for disease-modifying antirheumatic drug-naïve patients with rheumatoid arthritis
Sung, Y., & Lee, Y. H. (2020) · Zeitschrift für Rheumatologie · doi:10.1007/s00393-020-00889-x · Cited by 11
The best approach for functional tricuspid regurgitation: A network meta‐analysis
Mauro, M. D., Lorusso, R., Parolari, A., Ravaux, J. M., Bonalumi, G., Guarracini, S., Ricci, F., Benedetto, U., & Calafiore, A. M. (2021) · Journal of Cardiac Surgery · doi:10.1111/jocs.15378 · Cited by 11
“Analyses were performed using Bayesian Markov chain Monte Carlo modeling.(20) To provide a comparative hierarchy of procedural efficacy and safety, “Rankograms” with the surface under the cumulative ranking curve (SUCRA) probabilities were reported.”
Method
Complex solutions for a complex problem: A meta-analysis of the efficacy of multiple-behavior interventions on change in outcomes related to HIV.
Sunderrajan, A., White, B., Durantini, M. R., Sánchez, F., Glasman, L. R., & Albarracín, D. (2021) · Health Psychology · doi:10.1037/hea0001088 · Cited by 11
Treatments for macular degeneration: summarising evidence using network meta-analysis
Fadda, V., Maratea, D., Trippoli, S., & Messori, A. (2011) · British Journal of Ophthalmology · doi:10.1136/bjophthalmol-2011-300316 · Cited by 11
“Network meta-analysis (NMA) is a tool that summarises the information on comparative effectiveness when three or more treatments are proposed for the same clinical indication.(3) 4 NMA includes both direct comparisons (based on real trials) and indirect comparisons (based on statistical testing in the absence of a rea…”
Method
Effects of Treatment with Zofenopril in Men and Women with Acute Myocardial Infarction: Gender Analysis of the SMILE Program
Franconi, F., Omboni, S., Ambrosioni, E., Reggiardo, G., Campesi, I., & Borghi, C. (2014) · PLoS ONE · doi:10.1371/journal.pone.0111558 · Cited by 11

Authors: Caldwell, D. M., Ades, A. E., & Higgins, J. P. T.
Affiliations: University of Bristol (GB)
MRC Biostatistics Unit (GB)
Corresponding author: Caldwell, Deborah M
ORCID: Caldwell, Deborah M
Ades, A E
Higgins, J P T
Venue: BMJ
Publisher: BMJ
Published: 2005-10-13
Volume: 331
Issue: 7521
Pages: 897-900
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.331.7521.897
PMC: PMC1255806
OpenAlex: W1967385770
Cited by: 1,600
References: 37
Citations by year: 2026: 53 · 2025: 63 · 2024: 72 · 2023: 67 · 2022: 91 · 2021: 105 · 2020: 136 · 2019: 115 · 2018: 115 · 2017: 108 · 2016: 95 · 2015: 107 · 2014: 101 · 2013: 79 · 2012: 80
FWCI: 16.23
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.bmj.org/licenses/tdm/1.0/terms-and-conditions.html (tdm)
Locations: BMJ (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Explore Bristol Research (submittedVersion)
Topics: Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
Health Sciences › Medicine › Hematology › Methemoglobinemia and Tumor Lysis Syndrome
Keywords: rasburicase, allopurinol, hyperuricemia, lymphoma, pediatric oncology, direct and indirect evidence, treatment comparison
MeSH terms: Data Interpretation, Statistical, Decision Making, Humans, Meta-Analysis as Topic, Bias, Randomized Controlled Trials as Topic, Evidence-Based Medicine

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Simultaneous comparison of multiple treatments: Combining direct and indirect evidence.

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