Introducing the treatment hierarchy question in network meta-analysis

Abstract: Comparative effectiveness research using network meta-analysis can present a hierarchy of competing treatments, from the most to the least preferable option. However, in published reviews, the research question associated with the hierarchy of multiple interventions is typically not clearly defined. Here we introduce the novel notion of a treatment hierarchy question that describes the criterion for choosing a specific treatment over one or more competing alternatives. For example, stakeholders might ask which treatment is most likely to improve mean survival by at least 2 years, or which treatment is associated with the longest mean survival. We discuss the most commonly used ranking metrics (quantities that compare the estimated treatment-specific effects), how the ranking metrics produce a treatment hierarchy, and the type of treatment hierarchy question that each ranking metric can answer. We show that the ranking metrics encompass the uncertainty in the estimation of the treatment effects in different ways, which results in different treatment hierarchies. When using network meta-analyses that aim to rank treatments, investigators should state the treatment hierarchy question they aim to address and employ the appropriate ranking metric to answer it. Following this new proposal will avoid some controversies that have arisen in comparative effectiveness research

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch
Notes
American journal of epidemiology. - 191, 5 (2022) , 930-938, ISSN: 1476-6256

Event
Veröffentlichung
(where)
Freiburg
(who)
Universität
(when)
2022
Creator
Salanti, Georgia
Nikolakopoulou, Adriani
Efthimiou, Orestis
Mavridis, Dimitris
Egger, Matthias
White, Ian R.

DOI
10.1093/aje/kwab278
URN
urn:nbn:de:bsz:25-freidok-2302332
Rights
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
25.03.2025, 1:56 PM CET

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Associated

Time of origin

  • 2022

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