Enhancing capacity for network meta-analysis in Sub-Saharan Africa

Article type
Authors
Rohwer A1, Ngah V1, Young T1, Mavridis D2, McCaul M1
1Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University
2Department of Primary Education, School of Education, University of Ioannina
Abstract
Background:
The use of network meta-analysis (NMA) in systematic reviews (SRs) of effects is increasing. Despite skilled researchers and biostatisticians in Sub-Saharan Africa (SSA), with access to formal training in evidence synthesis, there is limited training in NMA.

Objectives:
To describe our experience with enhancing capacity for NMA in SSA.

Methods:
We developed two NMA online courses. The 8-week Primer in NMA SRs helped participants to find, appraise, interpret, and consider the use of NMA while the 5-week Global NMA Masterclass facilitated conduct of NMA using Stata and R. A multidisciplinary team collaborated to develop the content and format with text-based lessons, self-assessments, embedded lectures, asynchronous discussions, and weekly synchronous Q&A sessions. We integrated HIV/TB and COVID clinical examples. Participants provided feedback and facilitators reflected on implementation.

Results:
Forty-three participants (post-graduate students, clinicians, and decision-makers from various SSA countries) attended. They reported that the training was very relevant to their work. The self-directed, online learning approach enabled participants to learn at their convenience. However, some participants lacked motivation and commitment. As NMA is complex, requiring dedicated learning schedules, participants reported that they needed more time, and some would have preferred in-person learning. Using examples relevant to SSA and everyday problems encountered by clinicians made the learning more authentic.

Conclusions:
These were the first courses related to NMA offered in SSA. Harnessing the benefits of online learning while being cognizant of the challenges and striving to improve on the offering is key for future training. There is great potential to conduct NMA across SSA.

Patient, public, and/or healthcare consumer involvement: No direct involvement in the development and offering of our courses. However, given the significant interest in the examples used in the NMA workshop (HIV/TB and COVID), and their impact on patients’ lives and wellbeing, we would welcome public partnership in drawing attention to our findings.