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. 2014 Sep 20;33(21):3639-54.
doi: 10.1002/sim.6188. Epub 2014 Apr 29.

A design-by-treatment interaction model for network meta-analysis with random inconsistency effects

Dan Jackson  1 , Jessica K Barrett, Stephen Rice, Ian R White, Julian P T Higgins
Affiliations
Free PMC article

A design-by-treatment interaction model for network meta-analysis with random inconsistency effects

Dan Jackson et al. Stat Med. .
Free PMC article

Abstract

Network meta-analysis is becoming more popular as a way to analyse multiple treatments simultaneously and, in the right circumstances, rank treatments. A difficulty in practice is the possibility of 'inconsistency' or 'incoherence', where direct evidence and indirect evidence are not in agreement. Here, we develop a random-effects implementation of the recently proposed design-by-treatment interaction model, using these random effects to model inconsistency and estimate the parameters of primary interest. Our proposal is a generalisation of the model proposed by Lumley and allows trials with three or more arms to be included in the analysis. Our methods also facilitate the ranking of treatments under inconsistency. We derive R and I(2) statistics to quantify the impact of the between-study heterogeneity and the inconsistency. We apply our model to two examples.

Keywords: inconsistency; mixed treatment comparisons; multiple treatments meta-analysis; network meta-analysis; sensitivity analysis.

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Figures

Figure 1
Figure 1
Network diagram for the osteoarthritis of the knee data. Node size is proportional to the number of trials including the treatment, and multi-arm trials are shown as closed loops. Treatments are A: standard care, B: placebo, C: no medication, D: acupuncture, E: balneotherapy, F: braces, G: aerobic exercise, H: muscle exercise, I: heat treatment, J: insoles, K: tai chi, L: weight loss, M: sham acupuncture, N: ice/cooling, O: interferential, P: laser, Q: manual, R: NMES, S: PES, T: PEMF, U: static magnets, V: TENS.
Figure 2
Figure 2
Network diagram for the smoking cessation data. Node size is proportional to the number of trials including the treatment, and multi-arm trials are shown as closed loops. Treatments are A: no contact, B: self-help, C: individual counselling and D: group counselling.
See this image and copyright information in PMC

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