Journal article
Using the contribution matrix to evaluate complex study limitations in a network meta-analysis: a case study of bipolar maintenance pharmacotherapy review.
- Furukawa TA Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Yoshida Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan. furukawa@kuhp.kyoto-u.ac.jp.
- Miura T Department of Neuropsychiatry Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
- Chaimani A Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45110, Ioannina, Greece.
- Leucht S Department of Psychiatry and Psychotherapy, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany.
- Cipriani A Department of Psychiatry, University of Oxford, Warneford Lane, Headington, Oxford, OX3 7JX, UK.
- Noma H Department of Data Science, The Institute of Statistical Mathematics, 10-3 Midori-cho, Tachikawa, Tokyo, 190-8562, Japan.
- Mitsuyasu H Department of Neuropsychiatry Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
- Kanba S Department of Neuropsychiatry Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
- Salanti G Institute of Social and Preventive Medicine (ISPM) & Berner Institut für Hausarztmedizin (BIHAM), University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland.
- 2016-04-15
Published in:
- BMC research notes. - 2016
Enrichment design
GRADE
Network meta-analysis
Risk of bias
Study limitations
Algorithms
Bias
Bipolar Disorder
Humans
Maintenance Chemotherapy
Models, Theoretical
Network Meta-Analysis
Review Literature as Topic
English
BACKGROUND
Limitations in the primary studies constitute one important factor to be considered in the grading of recommendations assessment, development, and evaluation (GRADE) system of rating quality of evidence. However, in the network meta-analysis (NMA), such evaluation poses a special challenge because each network estimate receives different amounts of contributions from various studies via direct as well as indirect routes and because some biases have directions whose repercussion in the network can be complicated.
FINDINGS
In this report we use the NMA of maintenance pharmacotherapy of bipolar disorder (17 interventions, 33 studies) and demonstrate how to quantitatively evaluate the impact of study limitations using netweight, a STATA command for NMA. For each network estimate, the percentage of contributions from direct comparisons at high, moderate or low risk of bias were quantified, respectively. This method has proven flexible enough to accommodate complex biases with direction, such as the one due to the enrichment design seen in some trials of bipolar maintenance pharmacotherapy.
CONCLUSIONS
Using netweight, therefore, we can evaluate in a transparent and quantitative manner how study limitations of individual studies in the NMA impact on the quality of evidence of each network estimate, even when such limitations have clear directions.
Limitations in the primary studies constitute one important factor to be considered in the grading of recommendations assessment, development, and evaluation (GRADE) system of rating quality of evidence. However, in the network meta-analysis (NMA), such evaluation poses a special challenge because each network estimate receives different amounts of contributions from various studies via direct as well as indirect routes and because some biases have directions whose repercussion in the network can be complicated.
FINDINGS
In this report we use the NMA of maintenance pharmacotherapy of bipolar disorder (17 interventions, 33 studies) and demonstrate how to quantitatively evaluate the impact of study limitations using netweight, a STATA command for NMA. For each network estimate, the percentage of contributions from direct comparisons at high, moderate or low risk of bias were quantified, respectively. This method has proven flexible enough to accommodate complex biases with direction, such as the one due to the enrichment design seen in some trials of bipolar maintenance pharmacotherapy.
CONCLUSIONS
Using netweight, therefore, we can evaluate in a transparent and quantitative manner how study limitations of individual studies in the NMA impact on the quality of evidence of each network estimate, even when such limitations have clear directions.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1186/s13104-016-2019-1
- PMID 27074861
- Persistent URL
- https://sonar.ch/global/documents/278470
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