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Published in: BMC Medical Research Methodology 1/2015

Open Access 01-12-2015 | Correspondence

Emergent approaches to the meta-analysis of multiple heterogeneous complex interventions

Authors: G. J. Melendez-Torres, Chris Bonell, James Thomas

Published in: BMC Medical Research Methodology | Issue 1/2015

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Abstract

Background

Multiple interventions meta-analysis has been recommended in the methodological literature as a tool for evidence synthesis when a heterogeneous set of interventions is included in the same review—and, more recently, when a heterogeneous set of complex interventions is included. However, there is little guidance on the use of this method with complex interventions. This article suggests two approaches to model complexity and heterogeneity through this method.

Discussion

‘Clinically meaningful units’ groups interventions by modality or similar theory of change, whereas ‘components and dismantling’ separates out interventions into combinations of components and either groups interventions by the combination of components they demonstrate or extracts effects for each identified component and, possibly, interactions between components. Future work in systematic review methodology should aim to understand how to develop taxonomies of components or theories of change that are internally relevant to the studies in these multiple interventions meta-analyses.

Summary

Despite little meaningful prior guidance to its use in this context, multiple interventions meta-analysis has the potential to be a useful tool for synthesising heterogeneous sets of complex interventions. Researchers should choose an approach in accordance with their specific aims in their systematic review.
Literature
1.
go back to reference Salanti G. Indirect and mixed-treatment comparison, network, or multiple-treatments meta-analysis: many names, many benefits, many concerns for the next generation evidence synthesis tool. Res Synth Methods. 2012;3:80–97. doi:10.1002/jrsm.1037.CrossRefPubMed Salanti G. Indirect and mixed-treatment comparison, network, or multiple-treatments meta-analysis: many names, many benefits, many concerns for the next generation evidence synthesis tool. Res Synth Methods. 2012;3:80–97. doi:10.​1002/​jrsm.​1037.CrossRefPubMed
7.
go back to reference Weiss C, Connell J. New Approaches to Evaluating Community Initiatives: Concepts, Methods, and Contexts. Washington, D.C.: The Aspen Institute; 1995. Weiss C, Connell J. New Approaches to Evaluating Community Initiatives: Concepts, Methods, and Contexts. Washington, D.C.: The Aspen Institute; 1995.
11.
14.
go back to reference Dias S, Sutton AJ, Ades AE, Welton NJ. Evidence Synthesis for Decision Making 2: a Generalized Linear Modeling Framework for Pairwise and Network Meta-analysis of Randomized Controlled Trials. Med Decis Mak. 2013;33:607–17. doi:10.1177/0272989X12458724.CrossRef Dias S, Sutton AJ, Ades AE, Welton NJ. Evidence Synthesis for Decision Making 2: a Generalized Linear Modeling Framework for Pairwise and Network Meta-analysis of Randomized Controlled Trials. Med Decis Mak. 2013;33:607–17. doi:10.​1177/​0272989X12458724​.CrossRef
21.
go back to reference Mayo-Wilson E, Dias S, Mavranezouli I, Kew K, Clark DM, Ades AE, et al. Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry. 2014;1:368–76. doi:10.1016/S2215-0366(14)70329-3.CrossRefPubMed Mayo-Wilson E, Dias S, Mavranezouli I, Kew K, Clark DM, Ades AE, et al. Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry. 2014;1:368–76. doi:10.​1016/​S2215-0366(14)70329-3.CrossRefPubMed
23.
go back to reference Beck A. The Current State of Cognitive Therapy: a 40-Year Retrospective. Arch Gen Psychiatry. 2005;62:953–9.CrossRefPubMed Beck A. The Current State of Cognitive Therapy: a 40-Year Retrospective. Arch Gen Psychiatry. 2005;62:953–9.CrossRefPubMed
24.
go back to reference Kriston L, von Wolff A, Westphal A, Holzel LP, Harter M. Efficacy and acceptability of acute treatments for persistent depressive disorder: a network meta-analysis. Depress Anxiety. 2014;31:621–30. doi:10.1002/da.22236.CrossRefPubMed Kriston L, von Wolff A, Westphal A, Holzel LP, Harter M. Efficacy and acceptability of acute treatments for persistent depressive disorder: a network meta-analysis. Depress Anxiety. 2014;31:621–30. doi:10.​1002/​da.​22236.CrossRefPubMed
29.
go back to reference Cooper NJ, Kendrick D, Achana F, Dhiman P, He Z, Wynn P, et al. Network meta-analysis to evaluate the effectiveness of interventions to increase the uptake of smoke alarms. Epidemiol Rev. 2012;34:32–45. doi:10.1093/epirev/mxr015.CrossRefPubMed Cooper NJ, Kendrick D, Achana F, Dhiman P, He Z, Wynn P, et al. Network meta-analysis to evaluate the effectiveness of interventions to increase the uptake of smoke alarms. Epidemiol Rev. 2012;34:32–45. doi:10.​1093/​epirev/​mxr015.CrossRefPubMed
30.
go back to reference Welton NJ, Caldwell DM, Adamopoulos E, Vedhara K. Mixed treatment comparison meta-analysis of complex interventions: psychological interventions in coronary heart disease. Am J Epidemiol. 2009;169:1158–65. doi:10.1093/aje/kwp014.CrossRefPubMed Welton NJ, Caldwell DM, Adamopoulos E, Vedhara K. Mixed treatment comparison meta-analysis of complex interventions: psychological interventions in coronary heart disease. Am J Epidemiol. 2009;169:1158–65. doi:10.​1093/​aje/​kwp014.CrossRefPubMed
31.
go back to reference Madan J, Chen Y-F, Aveyard P, Wang D, Yahaya I, Munafo M, et al. Synthesis of evidence on heterogeneous interventions with multiple outcomes recorded over multiple follow-up times reported inconsistently: a smoking cessation case-study. J R Stat Soc Ser A (Statistics Soc). 2014;177:295–314. doi:10.1111/rssa.12018.CrossRef Madan J, Chen Y-F, Aveyard P, Wang D, Yahaya I, Munafo M, et al. Synthesis of evidence on heterogeneous interventions with multiple outcomes recorded over multiple follow-up times reported inconsistently: a smoking cessation case-study. J R Stat Soc Ser A (Statistics Soc). 2014;177:295–314. doi:10.​1111/​rssa.​12018.CrossRef
32.
go back to reference Collins LM, Murphy SA, Strecher V. The Multiphase Optimization Strategy (MOST) and the Sequential Multiple Assignment Randomized Trial (SMART). New Methods for More Potent eHealth Interventions. Am J Prev Med. 2007;32:112–8. doi:10.1016/j.amepre.2007.01.022.CrossRef Collins LM, Murphy SA, Strecher V. The Multiphase Optimization Strategy (MOST) and the Sequential Multiple Assignment Randomized Trial (SMART). New Methods for More Potent eHealth Interventions. Am J Prev Med. 2007;32:112–8. doi:10.​1016/​j.​amepre.​2007.​01.​022.CrossRef
34.
go back to reference Soares MO, Welton NJ, Harrison DA, Peura P, Shankar-Hari M, Harvey SE, et al. An evaluation of the feasibility, cost and value of information of a multicentre randomised controlled trial of intravenous immunoglobulin for sepsis (severe sepsis and septic shock): incorporating a systematic review, meta-analysis and value of information analysis. Health Technol Assess. 2012;16:1–186. doi:10.3310/hta16070.CrossRefPubMedCentral Soares MO, Welton NJ, Harrison DA, Peura P, Shankar-Hari M, Harvey SE, et al. An evaluation of the feasibility, cost and value of information of a multicentre randomised controlled trial of intravenous immunoglobulin for sepsis (severe sepsis and septic shock): incorporating a systematic review, meta-analysis and value of information analysis. Health Technol Assess. 2012;16:1–186. doi:10.​3310/​hta16070.CrossRefPubMedCentral
36.
go back to reference Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP, et al. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health. 2011;26:1479–98. doi:10.1080/08870446.2010.540664.CrossRefPubMed Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP, et al. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health. 2011;26:1479–98. doi:10.​1080/​08870446.​2010.​540664.CrossRefPubMed
Metadata
Title
Emergent approaches to the meta-analysis of multiple heterogeneous complex interventions
Authors
G. J. Melendez-Torres
Chris Bonell
James Thomas
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2015
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/s12874-015-0040-z

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