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A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis


Puhan, Milo A; Schünemann, Holger J; Murad, Mohammad Hassan; Li, Tianjing; Brignardello-Petersen, Romina; Singh, Jasvinder A; Kessels, Alfons G; Guyatt, Gordon H (2014). A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis. British Medical Journal, 349:g5630.

Abstract

Network meta-analysis (NMA), combining direct and indirect comparisons, is increasingly being used to examine the comparative effectiveness of medical interventions. Minimal guidance exists on how to rate the quality of evidence supporting treatment effect estimates obtained from NMA. We present a four-step approach to rate the quality of evidence in each of the direct, indirect, and NMA estimates based on methods developed by the GRADE working group. Using an example of a published NMA, we show that the quality of evidence supporting NMA estimates varies from high to very low across comparisons, and that quality ratings given to a whole network are uninformative and likely to mislead.

Abstract

Network meta-analysis (NMA), combining direct and indirect comparisons, is increasingly being used to examine the comparative effectiveness of medical interventions. Minimal guidance exists on how to rate the quality of evidence supporting treatment effect estimates obtained from NMA. We present a four-step approach to rate the quality of evidence in each of the direct, indirect, and NMA estimates based on methods developed by the GRADE working group. Using an example of a published NMA, we show that the quality of evidence supporting NMA estimates varies from high to very low across comparisons, and that quality ratings given to a whole network are uninformative and likely to mislead.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Date:2014
Deposited On:13 Feb 2015 12:22
Last Modified:27 Apr 2017 23:16
Publisher:BMJ Publishing Group
ISSN:0959-535X
Publisher DOI:https://doi.org/10.1136/bmj.g5630
PubMed ID:25252733

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