Graphs to enhance understanding and improve interpretability of the evidence from network meta-analysis

Article type
Authors
Chaimani A1, Salanti G2, Higgins J3, Mavridis D4, White I5, Spyridonos P6
1Department of Hygiene & Epidemiology, School of Medicine, University of Ioannina
2Ioannina University School of Medicine
3School of Social and Community Medicine, University of Bristol, UK
4Department of Hygiene & Epidemiology, School of Medicine, University of Ioannina, Greece
5MRC Biostatistics Unit, Cambridge, UK
6Department of Medical Physics, School of Medicine, University of Ioannina, Greece
Abstract
Objectives: To present and explain a series of graphical and numerical tools that can be used in network meta-analysis (NMA) in order to: 1) present the evidence base; 2) evaluate the assumptions; and 3) present the results. We offer Stata routines that can be used to produce the suggested graphs.
Description: This hands-on workshop begins with a brief presentation of the NMA model, and its main assumptions. We show how network meta-analysis can be performed in Stata. We introduce network plots that offer an overview of the evidence base and its characteristics. We present graphs that can be used to evaluate important assumptions of NMA; the presence of important inconsistency (disagreement between direct and indirect evidence), small-study effects (by extending the standard funnel plot) and heterogeneity (prediction plots). Finally, we discuss several graphical options for the presentation of NMA findings and for treatment ranking (such as plots of the cumulative ranking curves). Stata routines are provided for all graphical tools. Participants are requested to bring their laptops with the Stata 12 or 13 loaded.