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统计分析和个体参与者数据网络荟萃分析的质量欠佳:一项横断面研究。

Statistical analyses and quality of individual participant data network meta-analyses were suboptimal: a cross-sectional study.

机构信息

Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, No.199, Donggang West Road, Lanzhou City, 730000, Gansu Province, China.

The Second Clinical Medical College of Lanzhou University, Lanzhou, China.

出版信息

BMC Med. 2020 Jun 1;18(1):120. doi: 10.1186/s12916-020-01591-0.

Abstract

BACKGROUND

Network meta-analyses using individual participant data (IPD-NMAs) have been increasingly used to compare the effects of multiple interventions. Although there have been many studies on statistical methods for IPD-NMAs, it is unclear whether there are statistical defects in published IPD-NMAs and whether the reporting of statistical analyses has improved. This study aimed to investigate statistical methods used and assess the reporting and methodological quality of IPD-NMAs.

METHODS

We searched four bibliographic databases to identify published IPD-NMAs. The methodological quality was assessed using AMSTAR-2 and reporting quality assessed based on PRISMA-IPD and PRISMA-NMA. We performed stratified analyses and correlation analyses to explore the factors that might affect quality.

RESULTS

We identified 21 IPD-NMAs. Only 23.8% of the included IPD-NMAs reported statistical techniques used for missing participant data, 42.9% assessed the consistency, and none assessed the transitivity. None of the included IPD-NMAs reported sources of funding for trials included, only 9.5% stated pre-registration of protocols, and 28.6% assessed the risk of bias in individual studies. For reporting quality, compliance rates were lower than 50.0% for more than half of the items. Less than 15.0% of the IPD-NMAs reported data integrity, presented the network geometry, or clarified risk of bias across studies. IPD-NMAs with statistical or epidemiological authors often better assessed the inconsistency (P = 0.017). IPD-NMAs with a priori protocol were associated with higher reporting quality in terms of search (P = 0.046), data collection process (P = 0.031), and syntheses of results (P = 0.006).

CONCLUSIONS

The reporting of statistical methods and compliance rates of methodological and reporting items of IPD-NMAs were suboptimal. Authors of future IPD-NMAs should address the identified flaws and strictly adhere to methodological and reporting guidelines.

摘要

背景

使用个体参与者数据(IPD-NMA)的网络荟萃分析已越来越多地用于比较多种干预措施的效果。尽管已经有许多关于 IPD-NMA 的统计方法的研究,但尚不清楚已发表的 IPD-NMA 是否存在统计缺陷,以及统计分析的报告是否有所改进。本研究旨在调查所使用的统计方法,并评估 IPD-NMA 的报告和方法学质量。

方法

我们搜索了四个文献数据库,以确定已发表的 IPD-NMA。使用 AMSTAR-2 评估方法学质量,并根据 PRISMA-IPD 和 PRISMA-NMA 评估报告质量。我们进行了分层分析和相关性分析,以探讨可能影响质量的因素。

结果

我们确定了 21 项 IPD-NMA。只有 23.8%的纳入 IPD-NMA 报告了用于处理缺失参与者数据的统计技术,42.9%评估了一致性,没有一项评估了传递性。纳入的 IPD-NMA 均未报告试验资金来源,只有 9.5%的研究报告了方案的预先注册,并且只有 28.6%评估了个体研究的偏倚风险。在报告质量方面,超过一半的项目的符合率低于 50.0%。不到 15.0%的 IPD-NMA 报告了数据完整性,呈现了网络结构,或澄清了各研究之间的偏倚风险。具有统计学或流行病学背景的作者撰写的 IPD-NMA 通常更能评估一致性(P=0.017)。具有预先制定方案的 IPD-NMA 在搜索(P=0.046)、数据收集过程(P=0.031)和结果综合(P=0.006)方面具有更高的报告质量。

结论

IPD-NMA 的统计方法报告和方法学及报告项目的符合率不理想。未来的 IPD-NMA 作者应解决已确定的缺陷,并严格遵守方法学和报告指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57f8/7262764/8dd564d284fd/12916_2020_1591_Fig1_HTML.jpg

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