Universität zu Köln

Kiefer, Corinna, Sturtz, Sibylle and Bender, Ralf (2020). A simulation study to compare different estimation approaches for network meta-analysis and corresponding methods to evaluate the consistency assumption. BMC Med. Res. Methodol., 20 (1). LONDON: BMC. ISSN 1471-2288

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Abstract

Background Network meta-analysis (NMA) is becoming increasingly popular in systematic reviews and health technology assessments. However, there is still ambiguity concerning the properties of the estimation approaches as well as for the methods to evaluate the consistency assumption. Methods We conducted a simulation study for networks with up to 5 interventions. We investigated the properties of different methods and give recommendations for practical application. We evaluated the performance of 3 different models for complex networks as well as corresponding global methods to evaluate the consistency assumption. The models are the frequentist graph-theoretical approach netmeta, the Bayesian mixed treatment comparisons (MTC) consistency model, and the MTC consistency model with stepwise removal of studies contributing to inconsistency identified in a leverage plot. Results We found that with a high degree of inconsistency none of the evaluated effect estimators produced reliable results, whereas with moderate or no inconsistency the estimator from the MTC consistency model and the netmeta estimator showed acceptable properties. We also saw a dependency on the amount of heterogeneity. Concerning the evaluated methods to evaluate the consistency assumption, none was shown to be suitable. Conclusions Based on our results we recommend a pragmatic approach for practical application in NMA. The estimator from the netmeta approach or the estimator from the Bayesian MTC consistency model should be preferred. Since none of the methods to evaluate the consistency assumption showed satisfactory results, users should have a strong focus on the similarity as well as the homogeneity assumption.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kiefer, Corinna UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturtz, Sibylle UNSPECIFIED UNSPECIFIED UNSPECIFIED Bender, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-344125
DOI:	10.1186/s12874-020-0917-3
Journal or Publication Title:	BMC Med. Res. Methodol.
Volume:	20
Number:	1
Date:	2020
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2288
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INCONSISTENCY; MODEL Multiple languages Health Care Sciences & Services Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34412