How to Use an Article Reporting a Multiple Treatment Comparison Meta-analysis

被引:270
作者
Mills, Edward J. [1 ,2 ]
Ioannidis, John P. A. [3 ,4 ,5 ]
Thorlund, Kristian [2 ]
Schuenemann, Holger J. [2 ]
Puhan, Milo A. [6 ]
Guyatt, Gordon H. [2 ]
机构
[1] Univ Ottawa, Fac Hlth Sci, Ottawa, ON K1N 7K4, Canada
[2] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada
[3] Stanford Univ, Dept Med, Sch Med, Stanford Prevent Res Ctr, Stanford, CA 94305 USA
[4] Stanford Univ, Sch Med, Dept Hlth Res & Policy, Stanford Prevent Res Ctr, Stanford, CA 94305 USA
[5] Stanford Univ, Dept Stat, Sch Humanities & Sci, Stanford, CA 94305 USA
[6] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2012年 / 308卷 / 12期
基金
加拿大健康研究院;
关键词
MIXED TREATMENT COMPARISONS; RANDOMIZED-TRIALS; META-REGRESSION; EFFICACY; INCONSISTENCY; COMBINATION; BENEFITS; DISEASE; EXACERBATIONS; SURVIVAL;
D O I
10.1001/2012.jama.11228
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Multiple treatment comparison (MTC) meta-analysis uses both direct (head-to-head) randomized clinical trial (RCT) evidence as well as indirect evidence from RCTs to compare the relative effectiveness of all included interventions. The methodological quality of MTCs may be difficult for clinicians to interpret because the number of interventions evaluated may be large and the methodological approaches may be complex. Clinicians and others evaluating an MTC should be aware of the potential biases that can affect the interpretation of these analyses. Readers should consider whether the primary studies are sufficiently homogeneous to combine; whether the different interventions are sufficiently similar in their populations, study designs, and outcomes; and whether the direct evidence is sufficiently similar to the indirect evidence to consider combining. This article uses the existing Users' Guides format to address study validity, interpretation of results, and application to a patient scenario. JAMA. 2012;308(12):1246-1253 www.jama.com
引用
收藏
页码:1246 / 1253
页数:8
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