Bristol Medical School (Population Health Sciences), University of Bristol, Bristol, UK.
Centre for Reviews and Dissemination, University of York, York, UK.
Res Synth Methods. 2020 Jul;11(4):568-572. doi: 10.1002/jrsm.1416. Epub 2020 May 27.
Indirect comparisons are used to obtain estimates of relative effectiveness between two treatments that have not been compared in the same randomized controlled trial, but have instead been compared against a common comparator in separate trials. Standard indirect comparisons use only aggregate data, under the assumption that there are no differences in effect-modifying variables between the trial populations. Population-adjusted indirect comparisons aim to relax this assumption by using individual patient data (IPD) from one trial to adjust for differences in effect modifiers between populations. At present, the most commonly used approach is matching-adjusted indirect comparison (MAIC), where weights are estimated that match the covariate distributions of the reweighted IPD to the aggregate trial. MAIC was originally proposed using the method of moments to estimate the weights, but more recently entropy balancing has been proposed as an alternative. Entropy balancing has an additional "optimality" property ensuring that the weights are as uniform as possible, reducing the standard error of the estimates. In this brief method note, we show that MAIC weights are mathematically identical whether estimated using entropy balancing or the method of moments. Importantly, this means that the standard MAIC (based on the method of moments) also enjoys the "optimality" property. Moreover, the additional flexibility of entropy balancing suggests several interesting avenues for further research, such as combining population adjustment via MAIC with adjustments for treatment switching or nonparametric covariate adjustment.
间接比较用于获得两种未在同一项随机对照试验中进行比较的治疗方法的相对有效性估计,但在单独的试验中与共同对照物进行了比较。标准间接比较仅使用汇总数据,前提是试验人群中不存在效应修饰变量的差异。人群调整间接比较旨在通过使用一个试验的个体患者数据(IPD)来调整人群中效应修饰变量的差异来放松这一假设。目前,最常用的方法是匹配调整间接比较(MAIC),其中估计权重以匹配重新加权 IPD 的协变量分布与汇总试验。MAIC 最初是使用矩估计法来估计权重的,但最近提出了熵平衡作为替代方法。熵平衡具有额外的“最优性”特性,确保权重尽可能均匀,从而减少估计的标准误差。在这个简短的方法说明中,我们表明,无论使用熵平衡还是矩估计法来估计 MAIC 权重,它们在数学上都是相同的。重要的是,这意味着基于矩估计法的标准 MAIC 也具有“最优性”特性。此外,熵平衡的额外灵活性为进一步研究提供了几个有趣的途径,例如将通过 MAIC 进行的人群调整与治疗转换或非参数协变量调整相结合。