使用归一化熵衡量网络荟萃分析排名的不确定性。
Using Normalized Entropy to Measure Uncertainty of Rankings for Network Meta-analyses.
机构信息
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei.
出版信息
Med Decis Making. 2021 Aug;41(6):706-713. doi: 10.1177/0272989X21999023. Epub 2021 Mar 23.
Ranking of treatments offers a straightforward interpretation of results derived from network meta-analysis. However, some published network meta-analyses have overemphasized treatment ranking without paying attention to its uncertainty. According to a review of 91 network meta-analyses, 52 reported treatment ranking, but 43 of them did not report the uncertainty of ranking. Without reporting the uncertainty, small differences in the ranking of treatments may be overinterpreted. Rankograms, cumulative rankograms, the credible/confidence interval of mean rank, the surface under the cumulative ranking curve (SUCRA), and the interquartile range of median rank have been used to show the uncertainty of rankings. However, it is not always straightforward to compare the differences in the distribution of probabilities by inspecting rankograms or to compare the intervals or ranges of treatment ranks. We therefore proposed normalized entropy, which transforms the distribution of ranking probabilities into a single quantitative measure, to facilitate a refined interpretation of uncertainty of treatment ranking. We used 4 real examples to demonstrate the uncertainty of ranking quantified by ranking probabilities, 95% confidence interval of SUCRA, and normalized entropy. We showed that as normalized entropy ranges from 0 to 1 and is independent of the number of treatments, it can be used to compare the uncertainty of treatment ranking within a network meta-analysis (NMA) and between different NMAs. Normalized entropy is an alternative tool for measuring the uncertainty of treatment ranking by improving the translation of results from NMAs to clinical practice and avoiding naïve interpretation of treatment ranking. We therefore recommend normalized entropy to be included in the presentation and interpretation of results from NMAs.
治疗方法的排名为网络荟萃分析的结果提供了一种直接的解释。然而,一些已发表的网络荟萃分析过分强调了治疗方法的排序,而没有关注其不确定性。根据对 91 项网络荟萃分析的综述,有 52 项报告了治疗方法的排序,但其中有 43 项没有报告排序的不确定性。如果不报告不确定性,治疗方法排序的微小差异可能会被过度解读。排序图、累积排序图、平均排序可信区间、累积排序曲线下面积(SUCRA)和中位数排序的四分位间距已被用于显示排序的不确定性。然而,通过检查排序图来比较概率分布的差异,或者比较治疗排序的区间或范围,并不总是那么直接。因此,我们提出了归一化熵,它将排序概率的分布转化为一个单一的定量指标,以促进对治疗排序不确定性的精细解释。我们使用 4 个实际例子来说明由排序概率、SUCRA 的 95%置信区间和归一化熵量化的排序不确定性。我们表明,归一化熵的范围从 0 到 1,并且与治疗方法的数量无关,因此可以用于比较网络荟萃分析(NMA)内和不同 NMA 之间治疗方法排序的不确定性。归一化熵是衡量治疗方法排序不确定性的替代工具,它通过改善网络荟萃分析结果向临床实践的转化,避免对治疗方法排序的盲目解释。因此,我们建议在呈现和解释网络荟萃分析结果时纳入归一化熵。