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Simultaneous comparison of multiple treatments: Combining direct and indirect evidence.
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A randomized comparison between rasburicase and allopurinol in children with lymphoma or
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“To determine the comparative effects of statins, we conducted network meta-analyses.(27) This type of analysis allowed for combining the direct within-trial comparisons between two treatments (atorvastatin vs.”
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“It incorporates both direct and indirect evidence on the relative effects, and allows a statistical analysis of evidence consistency [3,16,46].”
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Self-citationSingle dose oral analgesics for acute postoperative pain in adults
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A primer on network meta-analysis with emphasis on mental health
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Adverse Effects of Second-Generation Antipsychotics in Children and Adolescents
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“All NMAs were performed using OpenBUGS software V.3.2.3 17 and R2OpenBUGS software V.3.2–3.2 18 in R (see eAppendix 6 in the online supplementary material 1 for the R Codes to Call OpenBUGS used for the NMA).”
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Self-citationImmunomodulators and immunosuppressants for multiple sclerosis: a network meta-analysis
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“Performing a network meta-analysis by borrowing information from indirect comparisons integrates information about relative treatment efficacy[18-20].”
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“This approach has advantages over the conventional pairwise meta-analysis such that it is able to assess the results of indirect as well as direct evidence and makes inferences on comparative effectiveness of interventions that have no head-tohead trials available.([16]) With increasing popularity of bariatric surgery…”
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“However, repeated pairwise application of MAIC is unlikely to result in a set of consistent treatment effect estimates—in the same way that multiple pairwise meta-analyses are unlikely to provide a set of consistent estimates (Caldwell et al., 2005).”
BackgroundSelf-citationPharmacological interventions for the treatment of delirium in critically ill adults
Burry, L. D., Hutton, B., Williamson, D. R., Mehta, S., Adhikari, N. K. J., Cheng, W., Ely, E. W., Egerod, I., Fergusson, D. A., & Rose, L. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011749.pub2 · Cited by 180
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Network meta-analysis explained
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“This results in greater precision of treatment effect estimates and the ability to rank all the interventions in a coherent way.(8) As for standard meta-analysis, NMA can be performed for most types of RCT outcomes, continuous, dichotomous, event rates and from survival models, using an appropriate scale (mean differe…”
BackgroundSelf-citationBallesio, A., Aquino, M. R. J. V., Feige, B., Johann, A. F., Kyle, S. D., Spiegelhalder, K., Lombardo, C., Rücker, G., Riemann, D., & Baglioni, C. (2018) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2017.01.006 · Cited by 172
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“NMA techniques enabled evidence synthesis from both direct and indirect comparisons between interventions, and allowed simultaneous inference on all treatments examined in pair-wise trial comparisons while respecting randomisation (Caldwell et al., 2005; Lu & Ades, 2004).”
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“By borrowing strength from indirect evidence to gain certainty about all treatment comparisons, network meta-analysis allows comparative effects that have not been investigated directly in randomised clinical trials to be estimated and ranked [22, 23].”
Network meta-analysis for comparing treatment effects of multiple interventions: an introduction
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“However, a potential drawback of traditional meta-analyses is their ability to compare no more than two treatments at a time, a significant obstacle for decision-making when the medical condition under study has many relevant treatment options to be considered in clinical practice [3–8].”
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Network meta-analysis of survival data with fractional polynomials
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“Meta-analysis models for the comparison of treatment B versus A can be extended to models allowing simultaneous comparisons of B versus A as well as C versus A [1-4].”
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“com comparisons for multiple interventions to provide an overall comparison (46-48).”
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“This method considers all trials simultaneously and enables integration of direct evidence from head-to-head trials (when they exist) with indirect evidence (through a common comparator) [53 (cid:1) 55].”
Phosphate-Binding Agents in Adults With CKD: A Network Meta-analysis of Randomized Trials
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“It implies that one can validly compare two interventions via a connected indirect ou e involving one or more intermediate comparators (21,22).”
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“We applied a mixed model to explore the effect of indirect comparison, which is thought to be the most appropriate method for multiple-treatments network meta-analysis.(16,43) Additionally, goodness of our model fit was relatively satisfactory, and posterior probability on some specific outcome of the Bayesian model c…”
MethodVALGENT: a protocol for clinical validation of human papillomavirus assays
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“The network meta-analyses relied on the key assumption that the relative treatment effect of one treatment versus another is the same across the entire set of studies [18,41].”
BackgroundMethodUterotonic agents for preventing postpartum haemorrhage: a network meta-analysis
Gallos, I. D., Papadopoulou, A., Man, R., Athanasopoulos, N., Tobı́as, A., Price, M. J., Williams, M. J., Diaz, V., Pasquale, J., Chamillard, M., et al. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011689.pub3 · Cited by 165
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“The key assumption of a random-effects mixedtreatment comparison model is that the treatment effects in each trial are different but from a common distribution.(13) This assumption is similar to that underlying standard pairwise meta-analysis but with the additional assumption that this common distribution is the same…”
ResultLabour induction with prostaglandins: a systematic review and network meta-analysis
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“To compare all treatments for metabolic syndrome reversal within a single model, we used mixed treatment comparison methods [19].”
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“agonists, adrenaline, anticholinergics) and steroids, alone or combined, for the acute management of bronchiolitis. We also determined the effectiveness of steroids with a fixed protocol for bronchodilator use compared with those in which the bronchodilator was given at the discretion of the attending physician, and b…”
MethodFakhri, Y., Bjørklund, G., Mohseni-Bandpei, A., Chirumbolo, S., Keramati, H., Pouya, R. H., Asadi, A., Amanidaz, N., Sarafraz, M., Sheikhmohammadi, A., et al. (2018) · Food and Chemical Toxicology · doi:10.1016/j.fct.2018.01.018 · Cited by 149
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Antidepressants for pain management in adults with chronic pain: a network meta-analysis
Birkinshaw, H., Friedrich, C., Cole, P., Eccleston, C., Serfaty, M. A., Stewart, G. B., White, S. P., Moore, A., Phillippo, D., & Pincus, T. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd014682.pub2 · Cited by 165
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Individual patient data network meta-analysis of mortality effects of implantable cardiac devices
Woods, B. S., Hawkins, N., Mealing, S., Sutton, A. J., Abraham, W. T., Beshai, J. F., Klein, H., Sculpher, M., Plummer, C., & Cowie, M. (2015) · Heart · doi:10.1136/heartjnl-2015-307634 · Cited by 140
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Self-citationDressings and topical agents for treating venous leg ulcers
Norman, G., Westby, M. J., Rithalia, A. D., Stubbs, N. C., Soares, M. O., & Dumville, J. C. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012583.pub2 · Cited by 149
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Tricco, A. C., Ashoor, H. M., Soobiah, C., Rios, P., Veroniki, A. A., Hamid, J. S., Ivory, J. D., Khan, P. A., Yazdi, F., Ghassemi, M., et al. (2018) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15069 · Cited by 137
“Transitivity is a critical NMA assumption that the included trials have similar characteristics across treatment comparisons.(6,12,13) The statistical notion of transitivity is the consistency assumption, in which different sources of evidence (e.”
BackgroundRahmani, J., Fakhri, Y., Shahsavani, A., Bahmani, Z., Urbina, M. A., Chirumbolo, S., Keramati, H., Moradi, B., Bay, A., & Bjørklund, G. (2018) · Food and Chemical Toxicology · doi:10.1016/j.fct.2018.06.023 · Cited by 137
“0 (Stata Corp, College Station, TX, USA) (Caldwell et al., 2005; Cipriani et al., 2013; Furukawa et al., 2016; Salanti et al., 2009).”
InfluentialCaldwell, D. M., Welton, N. J., & Ades, A. E. (2010) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2009.08.025 · Cited by 135
“The approach is equivalent to Gleser and Olkin [24] but offers a simple solution in standard software, which is derived from earlier work on MTC [19,21].”
BackgroundMethodSelf-citationNetwork meta-analysis: a norm for comparative effectiveness?
Higgins, J. P. T., & Welton, N. J. (2015) · The Lancet · doi:10.1016/s0140-6736(15)61478-7 · Cited by 133
“Complications and considerations in network meta-analysis have been discussed in several accessible texts.(7-12) Differences between network meta-analysis and standard meta-analysis are not, in our view, as substantial as many fear.”
BackgroundSelf-citationCorticosteroids in septic shock: a systematic review and network meta-analysis
Gibbison, B., López-López, J. A., Higgins, J. P. T., Miller, T., Angelini, G. D., Lightman, S. L., & Annane, D. (2017) · Critical Care · doi:10.1186/s13054-017-1659-4 · Cited by 142
“This approach makes use of both the direct comparisons available within trials and the indirect comparisons of interventions that can be made across trials when they use a common comparator intervention [10].”
MethodSelf-citationTeerawattanapong, N., Kengkla, K., Dilokthornsakul, P., Saokaew, S., Apisarnthanarak, A., & Chaiyakunapruk, N. (2017) · Clinical Infectious Diseases · doi:10.1093/cid/cix112 · Cited by 138
“A random-effects network meta-analysis was applied to compare all interventions using a combination of direct and indirect evidence together [27, 28].”
MethodA Bayesian missing data framework for generalized multiple outcome mixed treatment comparisons
Hong, H., Chu, H., Zhang, J., & Carlin, B. P. (2015) · Research Synthesis Methods · doi:10.1002/jrsm.1153 · Cited by 130
“Several articles assume that missing arms occur at random (Caldwell et al., 2005; Giovane et al., 2013), but such missingness is not considered in the standard LA approach, implying that, technically, LA assumes missingness is completely at random.”
Network Meta-analysis of Margin Threshold for Women With Ductal Carcinoma In Situ
Wang, S., Chu, H., Shamliyan, T., Jalal, H. J., Kuntz, K. M., Kane, R. L., & Virnig, B. A. (2012) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djs142 · Cited by 132
Skapinakis, P., Caldwell, D. M., Hollingworth, W., Bryden, P. A., Fineberg, N. A., Salkovskis, P. M., Welton, N. J., Baxter, H., Kessler, D. S., Churchill, R. C., et al. (2016) · Health Technology Assessment · doi:10.3310/hta20430 · Cited by 150
Self-citationBisphosphonates in multiple myeloma: a network meta-analysis
Mhaskar, R., Redzepovic, J., Wheatley, K., Clark, O. A. C., Miladinovic, B., Glasmacher, A., Kumar, A., & Djulbegovic, B. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003188.pub3 · Cited by 130
Golfinopoulos, V., Pentheroudakis, G. E., Salanti, G., Nearchou, A. D., Ioannidis, J. P. A., & Pavlidis, N. A. (2009) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2009.05.005 · Cited by 130
Yildiz, A., Nikodem, M., Vieta, E., Correll, C. U., & Baldessarini, R. J. (2015) · Psychological Medicine · doi:10.1017/s0033291714001305 · Cited by 128
“For MTM, we applied random-effects modeling for multi-arm studies with a Bayesian approach, using WinBUGS 1.4.3 software (Biostatistics Unit, Cambridge University, UK) based on Markov-chain Monte Carlo methods (Lu & Ades, 2004; Caldwell et al. 2005; Ades et al. 2006).”
BackgroundMethodInfluentialMcIntosh, B., Cameron, C. G., Singh, S. R., Yu, C., Ahuja, T. K., Welton, N. J., & Dahl, M. (2011) · Europe PMC (PubMed Central) · Cited by 129
'Third wave' cognitive and behavioural therapies versus other psychological therapies for depression
Hunot, V., Moore, T. H., Caldwell, D. M., Furukawa, T. A., Davies, P., Jones, H., Honyashiki, M., Chen, P., Lewis, G., & Churchill, R. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008704.pub2 · Cited by 124
Self-citationDANIELS, J. P., Middleton, L., Champaneria, R., Khan, K. S., Cooper, K. G., Mol, B. W., Bhattacharya, S., & on behalf of the International Heavy Menstrual Bleeding IPD Meta-analysis Collaborative Group (2012) · BMJ · doi:10.1136/bmj.e2564 · Cited by 128
Vegter, S., & Tolley, K. H. (2014) · PLoS ONE · doi:10.1371/journal.pone.0096829 · Cited by 126
Créquit, P., Trinquart, L., Yavchitz, A., & Ravaud, P. (2016) · BMC Medicine · doi:10.1186/s12916-016-0555-0 · Cited by 126
“With the increasing development of new treatments, examining networks of randomized trials is essential, and multiple treatment comparisons cannot be avoided [54].”
Backgroundde Zoete, R. M. J., Armfield, N. R., McAuley, J. H., Chen, K. S.-M., & Sterling, M. M. (2020) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-102664 · Cited by 139
Spadaccini, M., Iannone, A., Maselli, R., Badalamenti, M., Desai, M., Chandrasekar, V. T., Patel, H. K., Fugazza, A., Pellegatta, G., Galtieri, P. A., et al. (2021) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(21)00215-6 · Cited by 133
Aksan, A., Işık, H., Radeke, H. H., Dignass, A. U., & Stein, J. M. (2017) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.14043 · Cited by 123
Wang, L., Başer, O., Kutikova, L., Page, J. H., & Barron, R. L. (2015) · Supportive Care in Cancer · doi:10.1007/s00520-015-2686-9 · Cited by 127
“MTC is a generalized metaanalysis that offers greater statistical power by pooling direct and indirect evidence and assumes consistency between the two [25].”
BackgroundMatlaga, B. R., Jansen, J. P., Meckley, L. M., Byrne, T. W., & Lingeman, J. E. (2012) · The Journal of Urology · doi:10.1016/j.juro.2012.02.2569 · Cited by 123
Kriston, L., von Wolff, A., Westphal, A., Hölzel, L. P., & Härter, M. (2014) · Depression and Anxiety · doi:10.1002/da.22236 · Cited by 119
“Because sufficient similarity among the included trials is a key premise in network meta-analysis,[16] we controlled clinical heterogeneity by analyzing the available data across two networks.”
Behavioural therapies versus other psychological therapies for depression
Shinohara, K., Honyashiki, M., Imai, H., Hunot, V., Caldwell, D. M., Davies, P., Moore, T. H., Furukawa, T. A., & Churchill, R. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008696.pub2 · Cited by 129
Self-citationNetwork meta-analysis of randomized clinical trials: Reporting the proper summaries
Zhang, J., Carlin, B. P., Neaton, J. D., Soon, G. G., Nie, L., Kane, R. L., Virnig, B. A., & Chu, H. (2013) · Clinical Trials · doi:10.1177/1740774513498322 · Cited by 118
“In addition to some common concerns of NMA [5,10,39], there are some additional limitations for the proposed NMA approaches.”
BackgroundSaldanha, I. J., Dickersin, K., Wang, X., & Li, T. (2014) · PLoS ONE · doi:10.1371/journal.pone.0109400 · Cited by 123
“Cochrane ‘‘overviews’’ (Cochrane reviews which compile evidence from related reviews of interventions into a single accessible and usable document) [6], and network metaanalyses (analyses of three or more interventions for a given condition in one meta-analysis) [22]–[23] are examples of formal comparisons across syst…”
BackgroundUhlig, J., Strauß, A., Rücker, G., Hosseini, A. S. A., Lotz, J., Trojan, L., Kim, H. S., & Uhlig, A. (2018) · European Radiology · doi:10.1007/s00330-018-5660-3 · Cited by 121
“Benefits of network metaanalyses include increased statistical power and precision for comparisons of more than two treatments, incorporating both direct and indirect evidence [10, 11].”
BackgroundRahmani, J., Alipour, S., Miri, A., Fakhri, Y., Riahi, S.-M., Keramati, H., Moradi, M., Amanidaz, N., Pouya, R. H., Bahmani, Z., et al. (2018) · Food and Chemical Toxicology · doi:10.1016/j.fct.2018.06.016 · Cited by 118
Jansen, J. P. (2006) · Current Medical Research and Opinion · doi:10.1185/030079906x96308 · Cited by 118
Phillips, R. S., Friend, A. J., Gibson, F., Houghton, E., Gopaul, S., Craig, J. V., & Pizer, B. L. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007786.pub3 · Cited by 117
Metadata
- 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
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2005-10-13
- Volume
- 331
- Issue
- 7521
- Pages
- 897-900
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- 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
- 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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