tailieunhanh - Network meta-analysis: Users’ guide for pediatricians

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. | Al Khalifah et al. BMC Pediatrics 2018 18 180 https s12887-018-1132-9 DEBATE Open Access Network meta-analysis users guide for o pediatricians Reem Al Khalifah1 2 Ivan D. Florez1 3 Gordon Guyatt1 4 and Lehana Thabane1 5 Abstract 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 . 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. Keywords Network meta-analysis Multiple treatment comparisons Multiple-treatment meta-analysis evidence synthesis Evidence credibility Evidence certainty Pediatric Background Randomized control trials RCTs constitute the optimal methodology to determine the effectiveness of medical interventions. When results against placebo or standard care suggest benefits outweigh harms clinicians patients and families must choose among several interventions. Making this choice optimally requires access to systematic summaries of the best available .