Nilgün Yildiz,
- Associate Professor, Marmara University Göztepe Campus, University in Istanbul, Istanbul, Turkey
Abstract
A meta-analysis’s goal is typically to quantify the total treatment effect and draw conclusions regarding the differences in effects between the two treatments. Meta-analysis is a quantitative method for combining the findings of several studies in the social and medical sciences.. A meta-analysis might be of three typical forms. Network-wide, pairwise, and multivariate meta-analyses are all possible. The integrated assessment of more than two treatments is generally made possible by network meta-analysis (NMA). Mainly, frequentist and Bayesian frameworks are used to categorize statistical methods to NMA. Because a portion of NMA includes indirect, repeated comparisons, As network meta-analyses grow more popular, it is critical to introduce the method to readers and provide information on how to interpret the results. This chapter defines words used in network mental analysis (NMA), provides an overview of pertinent statistical concepts, and uses an example of a network containing Diabetes treatments and the R program to demonstrate the NMA analytic method based on the frequentist and bayesian framework. The article’s goal is to compare the fundamental ideas and analyses of network meta-analysis with diabetes data and employed treatment approaches.
Keywords: Network meta-analysis (NMA), diabetes treatment, R software, frequentist and Bayesian frameworks, statistical methods in meta-analysis
[This article belongs to Research & Reviews : Journal of Statistics ]
Nilgün Yildiz. Using the R Software to Conduct Network Meta-Analysis on Diabetes Data” h. Research & Reviews : Journal of Statistics. 2024; 13(02):57-76.
Nilgün Yildiz. Using the R Software to Conduct Network Meta-Analysis on Diabetes Data” h. Research & Reviews : Journal of Statistics. 2024; 13(02):57-76. Available from: https://journals.stmjournals.com/rrjost/article=2024/view=203186
References
- Shim SR, Yoon BY, Shin IS, Bae JM. Network meta-analysis: application and practice using Stata, Korean Society of Epidemiology 2017; 1-12
- Caldwell DM, Ades AE, Higgins JP. Simultaneous comparison of multiple treatments: combining direct and indirect evidence. BMJ. 2005;331:897-900.
- Li T, Vedula SS, Scherer R, Dickersin K. What comparative effectiveness research is needed? A framework for using guidelines and systematic reviews to identify evidence gaps and research priorities. Ann Intern Med. 2012;156:367- 77.
- Mitka M. US government kicks off program for comparative effectiveness research. JAMA. 2010;304:2230-1.
- Lu G, Ades AE. Assessing evidence inconsistency in mixed treatment comparisons. J Am Stat Assoc. 2006;101:447-59.
- Salanti G, Higgins JP, Ades AE, Ioannidis JP. Evaluation of networks of randomized trials. Stat Methods Med Res. 2008;17:279-301
- Higgins JP, Whitehead A. Borrowing strength from external trials in a meta-analysis. Stat Med. 1996;15:2733-49.
- Mills EJ, Ioannidis JP, Thorlund K, Schu¨nemann HJ, Puhan MA, Guyatt GH. How to use an article reporting a multiple treatment comparison metaanalysis. JAMA. 2012;308:1246-53.
- Bucher HC, Guyatt GH, Griffith LE, Walter SD. The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J Clin Epidemiol. 1997;50:683-91.
- Mills EJ, Ghement I, O’Regan C, Thorlund K. Estimating the power of indirect comparisons: a simulation study. PLoS One. 2011;6
- Ioannidis JP. Indirect comparisons: the mesh and mess of clinical trials. Lancet. 2006;368:1470-2.
- Cipriani A, Higgins JP, Geddes JR, Salanti G. Conceptual and technical challenges in network meta-analysis. Ann Intern Med 2013; 159:130-137.
- Tonin FS, Rotta I, Mendes AM, Pontarolo R. Network meta-analysis: a technique to gather evidence from direct and indirect comparisons. Pharm Pract (Granada) 2017;15:943.
- Hoaglin DC, Hawkins N, Jansen JP, Scott DA, Itzler R, Cappelleri JC, et al. Conducting indirect-treatment-comparison and networkmeta-analysis studies: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 2. Value Health 2011;14:429-437
- Li T, Puhan MA, Vedula SS, Singh S, Dickersin K; Ad Hoc Network Meta-analysis Methods Meeting Working Group. Network meta-analysis-highly attractive but more methodological research is needed. BMC Med 2011;9:79.
- Mills EJ, Bansback N, Ghement I, Thorlund K, Kelly S, Puhan MA, et al. Multiple treatment comparison meta-analyses: a step forward into complexity. Clin Epidemiol 2011;3:193-202.
- Reken S, Sturtz S, Kiefer C, Böhler YB, Wieseler B. Assumptions of mixed treatment comparisons in health technology assessments: challenges and possible steps for practical application. PLoS One 2016;11:e0160712
- Veroniki AA, Vasiliadis HS, Higgins JP, Salanti G. Evaluation of inconsistency in networks of interventions. Int J Epidemiol 2013; 42:332-345.
- Bhatnagar N, Lakshmi PV, Jeyashree K. Multiple treatment and indirect treatment comparisons: An overview of network metaanalysis. Perspect Clin Res 2014;5:154-158.
- Mills EJ, Thorlund K, Ioannidis JP. Demystifying trial networks and network meta-analysis. BMJ 2013;346:f2914.
- Salanti G. Indirect and mixed-treatment comparison, network, or multiple-treatments meta-analysis: many names, many benefits, many concerns for the next generation evidence synthesis tool. Res Synth Methods 2012;3:80-97
- Lu G, Ades AE. Combination of direct and indirect evidence in mixed treatment comparisons. Stat Med 2004;23:3105-3124.
- Jansen JP, Fleurence R, Devine B, Itzler R, Barrett A, Hawkins N, et al. Interpreting indirect treatment comparisons and network meta-analysis for health-care decision making: report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: part 1. Value Health 2011;14:417-428.
- Jansen JP, Naci H. Is network meta-analysis as valid as standard pairwise meta-analysis? It all depends on the distribution of effect modifiers. BMC Med 2013;11:159.
- Dakin HA, Welton NJ, Ades AE, Collins S, Orme M, Kelly S. Mixed treatment comparison of repeated measurements of a continuous endpoint: an example using topical treatments for primary openangle glaucoma and ocular hypertension. Stat Med 2011;30:2511- 2535.
- Schmitz S, Adams R, Walsh CD, Barry M, FitzGerald O. A mixed treatment comparison of the efficacy of anti-TNF agents in rheumatoid arthritis for methotrexate non-responders demonstrates differences between treatments: a Bayesian approach. Ann Rheum Dis 2012;71:225-230.
- Bucher HC, Guyatt GH, Griffith LE, Walter SD. The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J Clin Epidemiol 1997;50:683-691.
- Jones B, Roger J, Lane PW, Lawton A, Fletcher C, Cappelleri JC, et al. Statistical approaches for conducting network meta-analysis in drug development. Pharm Stat 2011;10:523-531.
- White IR. Network meta-analysis. Stata J 2015;15:951-985.
- Caldwell DM, Ades AE, Higgins JP. Simultaneous comparison of multiple treatments: combining direct and indirect evidence. BMJ. 2005;331:897-900
- Cooper NJ, Peters J, Lai MC, et al. How valuable are multiple treatment comparison methods in evidence-based health-care evaluation? Value Health. 2011;14(2):371–380
- Edwards SJ, Clarke MJ, Wordsworth S, Borrill J. 2009. Indirect comparisons of treatments based on systematic reviews of randomised controlled trials. International Journal of Clinical Practice 63: 841–854. DOI:10.1111/ j.1742-1241.2009.02072
- Gartlehner G, Moore CG. 2008. Direct versus indirect comparisons: a summary of the evidence. The International Journal of Technology Assessment in Health Care 24: 170–177. DOI:10.1017/S0266462308080240.
- Ioannidis JP. 2006. Indirect comparisons: the mesh and mess of clinical trials. Lancet 368: 1470–1472. DOI:10.1016/ S0140-6736(06)69615-3.
- Efthimiou, O., Debray, T. P. A., vanValkenhoef, G., Trelle, S., Panayidou, K., Moons, K. G. M., Salanti, G. (2016). GetReal in network meta-analysis: A review of the methodology. Research Synthesis Methods, 7, 236–263. https://doi.org/10.1002/jrsm.1195
- Salanti G, Kavvoura FK, Ioannidis JP. 2008b. Exploring the geometry of treatment networks. Annals of Internal Medicine 148: 544–553.
- Higgins JPT, Jackson D, Barrett JK, Lu G, Ades AE, White IR. 2012. Consistency and inconsistency in network meta-analysis: concepts and models for multi-arm studies. Res Synth Meth 3: 98–110.
- Higgins JPT. 2008. Commentary: heterogeneity in meta-analysis should be expected and appropriately quantified. International Journal of Epidemiology 37: 1158–1160.
- Chan AW, Altman DG. 2005. Epidemiology and reporting of randomised trials published in PubMed journals. The Lancet 365: 1159–1162.
- Dias S, Welton NJ, Caldwell DM, Ades AE. 2010b. Checking consistency in mixed treatment comparison meta- analysis. Statistics in Medicine 29: 932–944. DOI:10.1002/sim.3767.
- Song F, Loke YK, Walsh T, Glenny AM, Eastwood AJ, Altman DG. 2009. Methodological problems in the use of indirect comparisons for evaluating healthcare interventions: survey of published systematic reviews. BMJ 338: b1147
- Baker SG, Kramer BS. 2002. The transitive fallacy for randomized trials: if A bests B and B bests C in separate trials, is A better than C? BMC Medical Research Methodology 2: 13.
- Donegan S, Williamson P, Gamble C, Tudur SC. 2010. Indirect comparisons: a review of reporting and methodological quality. PLoS One 5: e11054. DOI:10.1371
- Song F, Altman DG, Glenny AM, Deeks JJ. 2003. Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses. BMJ 326: 472. DOI:10.1136/ bmj.326.7387.472.
- Dias S, Welton NJ, Sutton AJ, Caldwell DM, Lu G, Ades AE. 2013d. Evidence synthesis for decision making 4: inconsistency in networks of evidence based on randomized controlled trials. Medical Decision Making 33:641–656. DOI:10.1177/0272989X12455847.
- Jansen JP, Naci H. 2013. Is network meta-analysis as valid as standard pairwise meta-analysis? It all depends on the distribution of effect modifiers. BMC Medicine 11: 159. DOI:10.1186/1741-7015-11-159.
- Donegan S, Williamson P, D’Alessandro U, Tudur Smith C. 2013b. Assessing key assumptions of network meta-analysis: a review of methods. Research Synthesis Methods 4: 291–323. DOI:10.1002/jrsm.1085.
- Salanti G, Marinho V, Higgins JP. 2009. A case study of multiple-treatments meta-analysis demonstrates that covariates should be considered. Journal of Clinical Epidemiology 62:857–864. DOI:10.1016/j.jclinepi.2008.10.001.
- Julious SA, Wang SJ. 2008. How biased are indirect comparisons, particularly when comparisons are made over time in controlled trials. Drug Information Journal 42: 625
- Lu G, Ades A. 2009. Modeling between-trial variance structure in mixed treatment comparisons. Biostatistics 10: 792–805. DOI:10.1093/biostatistics/kxp032.
- Lumley T. 2002. Network meta-analysis for indirect treatment comparisons. Statistics in Medicine 21: 2313–2324. DOI:10.1002/sim.1201.
- Salanti G. Indirect and mixed-treatment comparison, network, or multiple-treatments meta-analysis: many names, many benefits, many concerns for the next generation evidence synthesis tool. Res Synth Methods. 2012;3:80–97.
- Senn S, Gavini F, Magrez D, Scheen A. Issues in performing a network meta-analysis. Stat Methods Med Res. 2013 Apr;22(2):169-89. doi: 10.1177/0962280211432220. Epub 2012 Jan 3. PMID: 22218368.
- König, J., Krahn, U., and Binder, H. (2013). Visualizing the flow of evidence in network meta-analysis and characterizing mixed treatment comparisons. Statistics in Medicine, 32(30):5414–5429.
- Rücker, G. and Schwarzer, G. (2015). Ranking treatments in frequentist network meta-analysis works without resampling methods. BMC medical research methodology, 15(1):58.
- Mbuagbaw, L., Rochwerg, B., Jaeschke, R., Heels-Andsell, D., Alhazzani, W., Thabane, L., and Guyatt, G. H. (2017). Approaches to interpreting and choosing the best treatments in network meta-analyses. Systematic reviews, 6(1):79.
- Schwarzer, G., Carpenter, J. R., and Rücker, G. (2015). Meta-analysis with R. Springer
- Seitidis, G., Nikolakopoulos, S., Hennessy, E. et al. Network Meta-Analysis Techniques for Synthesizing Prevention Science Evidence. Prev Sci (2021). https://doi.org/10.1007/s11121-021-01289-6

Research & Reviews : Journal of Statistics
| Volume | 13 |
| Issue | 02 |
| Received | 07/08/2024 |
| Accepted | 15/08/2024 |
| Published | 20/08/2024 |
| Publication Time | 13 Days |
Login
PlumX Metrics