Approaches to interpreting and choosing the best treatments in network meta-analyses

doi:10.1186/s13643-017-0473-z

Editorial

. 2017 Apr 12;6(1):79.

doi: 10.1186/s13643-017-0473-z.

Approaches to interpreting and choosing the best treatments in network meta-analyses

L Mbuagbaw^{1

2

3}, B Rochwerg^{1

4}, R Jaeschke^{1

4}, D Heels-Andsell¹, W Alhazzani^{1

4}, L Thabane^{1

2

5

6

7

8}, Gordon H Guyatt^{9

10

11}

Affiliations

¹ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
² Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada.
³ Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon.
⁴ Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁵ Department of Paediatrics, McMaster University, Hamilton, ON, Canada.
⁶ Centre for Evaluation of Medicine, St Joseph's Healthcare-Hamilton, Hamilton, ON, Canada.
⁷ Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada.
⁸ Department of Anaesthesia, McMaster University, Hamilton, ON, Canada.
⁹ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. guyatt@mcmaster.ca.
¹⁰ Department of Medicine, McMaster University, Hamilton, ON, Canada. guyatt@mcmaster.ca.
¹¹ CLARITY Research Group, Department of Clinical Epidemiology & Biostatistics, McMaster University, Room 2C12, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada. guyatt@mcmaster.ca.

PMID: 28403893
PMCID: PMC5389085
DOI: 10.1186/s13643-017-0473-z

Editorial

Approaches to interpreting and choosing the best treatments in network meta-analyses

L Mbuagbaw et al. Syst Rev. 2017.

. 2017 Apr 12;6(1):79.

doi: 10.1186/s13643-017-0473-z.

Authors

L Mbuagbaw^{1

2

3}, B Rochwerg^{1

4}, R Jaeschke^{1

4}, D Heels-Andsell¹, W Alhazzani^{1

4}, L Thabane^{1

2

5

6

7

8}, Gordon H Guyatt^{9

10

11}

Affiliations

¹ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
² Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada.
³ Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon.
⁴ Department of Medicine, McMaster University, Hamilton, ON, Canada.
⁵ Department of Paediatrics, McMaster University, Hamilton, ON, Canada.
⁶ Centre for Evaluation of Medicine, St Joseph's Healthcare-Hamilton, Hamilton, ON, Canada.
⁷ Population Health Research Institute, Hamilton Health Sciences, Hamilton, ON, Canada.
⁸ Department of Anaesthesia, McMaster University, Hamilton, ON, Canada.
⁹ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada. guyatt@mcmaster.ca.
¹⁰ Department of Medicine, McMaster University, Hamilton, ON, Canada. guyatt@mcmaster.ca.
¹¹ CLARITY Research Group, Department of Clinical Epidemiology & Biostatistics, McMaster University, Room 2C12, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada. guyatt@mcmaster.ca.

PMID: 28403893
PMCID: PMC5389085
DOI: 10.1186/s13643-017-0473-z

Abstract

When randomized trials have addressed multiple interventions for the same health problem, network meta-analyses (NMAs) permit researchers to statistically pool data from individual studies including evidence from both direct and indirect comparisons. Grasping the significance of the results of NMAs may be very challenging. Authors may present the findings from such analyses in several numerical and graphical ways. In this paper, we discuss ranking strategies and visual depictions of rank, including the surface under the cumulative ranking (SUCRA) curve method. We present ranking approaches' merits and limitations and provide an example of how to apply the results of a NMA to clinical practice.

Keywords: Advantages; Limitations; Network meta-analysis; Ranking; SUCRA.

PubMed Disclaimer

Figures

**Fig. 1**
Graphical ranking of resuscitation fluids in six-node analysis

**Fig. 2**
Point estimates and confidence intervals of comparisons between the five alternative resuscitation fluids and light starch

See this image and copyright information in PMC

Cited by

The Value of Indirect Comparisons of Systemic Biologics for Psoriasis: Interpretation of Efficacy Findings.
Augustin M, Schuster C, Mert C, Nast A. Augustin M, et al. Dermatol Ther (Heidelb). 2022 Aug;12(8):1711-1727. doi: 10.1007/s13555-022-00765-3. Epub 2022 Jul 14. Dermatol Ther (Heidelb). 2022. PMID: 35834062 Free PMC article. Review.
Efficacy and safety of antithrombotic therapy for preventing and treating pediatric thromboembolic disease: a systematic review.
Gao H, Chen M, Huang Y, Liu H, Lin Y, Chen M. Gao H, et al. Sci Rep. 2024 Jun 11;14(1):13378. doi: 10.1038/s41598-024-64334-8. Sci Rep. 2024. PMID: 38862574 Free PMC article.
Evidence-based exercise recommendations to improve functional mobility in older adults - A study protocol for living systematic review and meta-analysis.
Wollesen B, Yellon T, Langeard A, Belkin V, Wunderlich A, Giannouli E, Qian G, Bernades RA, Ossowski Z, Marusic U, Sighdel R, Netz Y, Volecker-Rehage C. Wollesen B, et al. Open Res Eur. 2025 Jan 14;4:202. doi: 10.12688/openreseurope.17823.2. eCollection 2024. Open Res Eur. 2025. PMID: 39871858 Free PMC article.
Comparative efficacy of different exercise types on body composition in university students: a systematic review and meta-analysis of randomized controlled trials.
Li J, Zang L, Hao S, Wang H. Li J, et al. Front Physiol. 2025 Apr 22;16:1537937. doi: 10.3389/fphys.2025.1537937. eCollection 2025. Front Physiol. 2025. PMID: 40330251 Free PMC article.
Partially systematic thoughts on the history of systematic reviews.
Clarke M. Clarke M. Syst Rev. 2018 Oct 27;7(1):176. doi: 10.1186/s13643-018-0833-3. Syst Rev. 2018. PMID: 30368251 Free PMC article.

See all "Cited by" articles

References

1. Khan KS, Kunz R, Kleijnen J, Antes G. Five steps to conducting a systematic review. J R Soc Med. 2003;96:118–121. doi: 10.1258/jrsm.96.3.118. - DOI - PMC - PubMed
1. Greenhalgh T. How to read a paper: papers that summarise other papers (systematic reviews and meta-analyses) BMJ. 1997;315:672–675. doi: 10.1136/bmj.315.7109.672. - DOI - PMC - PubMed
1. Cipriani A, Barbui C, Rizzo C, Salanti G. What is a multiple treatments meta-analysis? Epidemiol Psychiatr Sci. 2012;21:151–153. doi: 10.1017/S2045796011000837. - DOI - PubMed
1. Miller FG, Brody H. What makes placebo-controlled trials unethical? Am J Bioeth. 2002;2:3–9. doi: 10.1162/152651602317533523. - DOI - PubMed
1. Mills EJ, Thorlund K, Ioannidis JP. Demystifying trial networks and network meta-analysis. BMJ. 2013;346:f2914. doi: 10.1136/bmj.f2914. - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations

[1] Khan KS, Kunz R, Kleijnen J, Antes G. Five steps to conducting a systematic review. J R Soc Med. 2003;96:118–121. doi: 10.1258/jrsm.96.3.118. - DOI - PMC - PubMed

[2] Khan KS, Kunz R, Kleijnen J, Antes G. Five steps to conducting a systematic review. J R Soc Med. 2003;96:118–121. doi: 10.1258/jrsm.96.3.118. - DOI - PMC - PubMed

[3] Greenhalgh T. How to read a paper: papers that summarise other papers (systematic reviews and meta-analyses) BMJ. 1997;315:672–675. doi: 10.1136/bmj.315.7109.672. - DOI - PMC - PubMed

[4] Greenhalgh T. How to read a paper: papers that summarise other papers (systematic reviews and meta-analyses) BMJ. 1997;315:672–675. doi: 10.1136/bmj.315.7109.672. - DOI - PMC - PubMed

[5] Cipriani A, Barbui C, Rizzo C, Salanti G. What is a multiple treatments meta-analysis? Epidemiol Psychiatr Sci. 2012;21:151–153. doi: 10.1017/S2045796011000837. - DOI - PubMed

[6] Cipriani A, Barbui C, Rizzo C, Salanti G. What is a multiple treatments meta-analysis? Epidemiol Psychiatr Sci. 2012;21:151–153. doi: 10.1017/S2045796011000837. - DOI - PubMed

[7] Miller FG, Brody H. What makes placebo-controlled trials unethical? Am J Bioeth. 2002;2:3–9. doi: 10.1162/152651602317533523. - DOI - PubMed

[8] Miller FG, Brody H. What makes placebo-controlled trials unethical? Am J Bioeth. 2002;2:3–9. doi: 10.1162/152651602317533523. - DOI - PubMed

[9] Mills EJ, Thorlund K, Ioannidis JP. Demystifying trial networks and network meta-analysis. BMJ. 2013;346:f2914. doi: 10.1136/bmj.f2914. - DOI - PubMed

[10] Mills EJ, Thorlund K, Ioannidis JP. Demystifying trial networks and network meta-analysis. BMJ. 2013;346:f2914. doi: 10.1136/bmj.f2914. - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Approaches to interpreting and choosing the best treatments in network meta-analyses

Affiliations

Approaches to interpreting and choosing the best treatments in network meta-analyses

Authors

Affiliations

Abstract

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Abstract

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Other Literature Sources