Evidence Synthesis of Treatment Efficacy in Decision Making: A Reviewer's Checklist [Internet]

Excerpt

This checklist is for the review of evidence syntheses for treatment efficacy used in decision making based on either efficacy or cost-effectiveness. It is intended to be used for pair-wise meta-analysis, indirect comparisons, and network meta-analysis, without distinction. It does not generate a quality rating, and is not prescriptive. Instead it focuses on a series of questions aimed at revealing the assumptions that the authors of the synthesis are expecting reviewers to accept, on the adequacy of the arguments authors advance in support of their position, and the need for further analyses or sensitivity analyses. The checklist is intended primarily for those who review evidence syntheses, including indirect comparisons and network metaanalyses, in the context of decision making but will also be of value to those submitting syntheses for review, whether to decision making bodies or journals.

The checklist has four main headings:

A. Definition of the decision problem, including: target population for decision; comparators; trial inclusion criteria; treatment definition; trial outcomes; scale of measurement for synthesis; patient population in the trials in relation to the target population; trial quality; presentation of the data. B. Methods of analysis and presentation of results, including: description of metaanalytic methods; heterogeneity in relative treatment effects; baseline models for trial outcomes; presentations of results. C. Issues specific to network synthesis, including: model specification; multi-arm trials; connected and disconnected networks; inconsistency. D. Embedding the synthesis in a probabilistic cost-effectiveness model, including the propagation of parameter uncertainty and correlations.

The headings and implicit advice follow directly from the other Technical Support Documents (TSD) in this series. A simple table is provided that could serve as a pro forma checklist.

Keywords: cost-effectiveness analysis; Bayesian meta-analysis; multiparameter evidence synthesis; meta-analysis; network meta-analysis.