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BMC Medicine
Published in: BMC Medicine 1/2017

Open Access 01-12-2017 | Research article

Characteristics and knowledge synthesis approach for 456 network meta-analyses: a scoping review

Authors: Wasifa Zarin, Areti Angeliki Veroniki, Vera Nincic, Afshin Vafaei, Emily Reynen, Sanober S. Motiwala, Jesmin Antony, Shannon M. Sullivan, Patricia Rios, Caitlin Daly, Joycelyne Ewusie, Maria Petropoulou, Adriani Nikolakopoulou, Anna Chaimani, Georgia Salanti, Sharon E. Straus, Andrea C. Tricco

Published in: BMC Medicine | Issue 1/2017

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Abstract

Background

Network meta-analysis (NMA) has become a popular method to compare more than two treatments. This scoping review aimed to explore the characteristics and methodological quality of knowledge synthesis approaches underlying the NMA process. We also aimed to assess the statistical methods applied using the Analysis subdomain of the ISPOR checklist.

Methods

Comprehensive literature searches were conducted in MEDLINE, PubMed, EMBASE, and Cochrane Database of Systematic Reviews from inception until April 14, 2015. References of relevant reviews were scanned. Eligible studies compared at least four different interventions from randomised controlled trials with an appropriate NMA approach. Two reviewers independently performed study selection and data abstraction of included articles. All discrepancies between reviewers were resolved by a third reviewer. Data analysis involved quantitative (frequencies) and qualitative (content analysis) methods. Quality was evaluated using the AMSTAR tool for the conduct of knowledge synthesis and the ISPOR tool for statistical analysis.

Results

After screening 3538 citations and 877 full-text papers, 456 NMAs were included. These were published between 1997 and 2015, with 95% published after 2006. Most were conducted in Europe (51%) or North America (31%), and approximately one-third reported public sources of funding. Overall, 84% searched two or more electronic databases, 62% searched for grey literature, 58% performed duplicate study selection and data abstraction (independently), and 62% assessed risk of bias. Seventy-eight (17%) NMAs relied on previously conducted systematic reviews to obtain studies for inclusion in their NMA. Based on the AMSTAR tool, almost half of the NMAs incorporated quality appraisal results to formulate conclusions, 36% assessed publication bias, and 16% reported the source of funding. Based on the ISPOR tool, half of the NMAs did not report if an assessment for consistency was conducted or whether they accounted for inconsistency when present. Only 13% reported heterogeneity assumptions for the random-effects model.

Conclusions

The knowledge synthesis methods and analytical process for NMAs are poorly reported and need improvement.
Appendix
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Metadata
Title
Characteristics and knowledge synthesis approach for 456 network meta-analyses: a scoping review
Authors
Wasifa Zarin
Areti Angeliki Veroniki
Vera Nincic
Afshin Vafaei
Emily Reynen
Sanober S. Motiwala
Jesmin Antony
Shannon M. Sullivan
Patricia Rios
Caitlin Daly
Joycelyne Ewusie
Maria Petropoulou
Adriani Nikolakopoulou
Anna Chaimani
Georgia Salanti
Sharon E. Straus
Andrea C. Tricco
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2017
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-016-0764-6

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