Use of indirect comparison methods in systematic reviews: A survey of Cochrane review authorsá views

Tags: Poster
Abdelhamid A1, Loke Y1, Parekh S2, Chen Y3, Sutton A4, Eastwood A5, Holland R1, Song F1
1University of East Anglia, UK, 2NETSCC- University of Southhampton, UK, 3University of Birmingham, UK, 4University of Leicester, UK, 5University of York, UK

Background: Many systematic reviews have evaluated multiple interventions for a particular condition, but such reviews often do not formally compare the relative effectiveness of interventions through adjusted indirect comparison (AIC) or network meta-analysis. The use of AIC has recently attracted growing interest.

Objectives: To investigate the views and knowledge of Cochrane systematic review (CSR) authors regarding the use of AIC.

Methods: An online survey was sent to 84 CSR corresponding authors of reviews we had identified as reviews in which direct comparisons (DC) as well as AIC of interventions would have been possible. Authors were also sent results of DC and AIC compiled using data from their particular review.

Results: Response rate was 57%. Respondents were academics (54%), clinicians (27%) or with equally shared roles (19%). When conducting the review in question, only one quarter of authors had known about AIC methods and have used them while over a third (35%) had knowledge of the methods but had not used them. Forty percent (40%) either did not know about AIC or had only heard about it. The majority of authors (76%) would, at least sometimes, consider evidence from AIC. Some authors expressed suspicion of the methods. Most authors (89%) felt they needed more training, especially in assessing the validity of AIC. Almost all authors felt that AIC could potentially be influenced by a huge number of effect modifiers. Some respondents accepted that use of AIC is needed as it may be the only source of information for relative effectiveness of competing interventions, provided that authors and readers are conscious of its limitations. Time commitment and resources needed were identified as important concerns for Cochrane reviewers.

Conclusions: There is mostly an acceptance of the increasing demand for AIC as well as an urgent need to develop structured guidance and training for its use and interpretation.