Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Res Synth Methods. 2012 Jun;3(2):80-97. doi: 10.1002/jrsm.1037. Epub 2012 Jun 11.
The ever increasing number of alternative treatment options and the plethora of clinical trials have put systematic reviews and meta-analysis under a new perspective by emphasizing the need to make inferences about competing treatments for the same condition. The statistical component in reviews that compare multiple interventions, network meta-analysis, is the next generation evidence synthesis toolkit which, when properly applied, can serve decision-making better than the established pairwise meta-analysis. The criticism and enthusiasm for network meta-analysis echo those that greeted the advent of simple meta-analysis. The main criticism is associated with the difficulty in evaluating the assumption underlying the statistical synthesis of direct and indirect evidence. In the present article, the assumption of the network meta-analysis are presented using various formulations, the statistical and nonstatistical methodological considerations are elucidated, and the progress achieved in this field is summarized. Throughout, focus is put on highlighting the analogy between the concerns and difficulties that the scientific community had some time ago when advancing from individual trials to their quantitative synthesis via meta-analysis and those currently expressed about the transition from head-to-head meta-analyses to network meta-analysis. Copyright © 2012 John Wiley & Sons, Ltd.
不断增加的替代治疗选择和大量的临床试验通过强调需要对同一疾病的竞争治疗做出推断，为系统评价和荟萃分析带来了新的视角。在比较多种干预措施的综述中，网络荟萃分析是下一代证据综合工具包，如果正确应用，它可以比既定的两两荟萃分析更好地为决策提供服务。对网络荟萃分析的批评和热情反映了那些对简单荟萃分析出现的批评和热情。主要的批评与评估直接和间接证据统计综合的假设的难度有关。在本文中，使用各种公式呈现了网络荟萃分析的假设，阐明了统计和非统计方法学方面的考虑，并总结了该领域的进展。在整个过程中，重点强调了科学界在从个体试验到通过荟萃分析进行定量综合时所面临的关注和困难，以及当前从头对头荟萃分析到网络荟萃分析的转变所表达的关注和困难之间的相似之处。版权所有 © 2012 约翰威立父子有限公司。
