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Review
. 2017 Oct 27:39:e2017047.
doi: 10.4178/epih.e2017047. eCollection 2017.

Network meta-analysis: application and practice using Stata

Sungryul Shim  1 , Byung-Ho Yoon  2 , In-Soo Shin  3 , Jong-Myon Bae  4
Affiliations
Review

Network meta-analysis: application and practice using Stata

Sungryul Shim et al. Epidemiol Health. .

Abstract

This review aimed to arrange the concepts of a network meta-analysis (NMA) and to demonstrate the analytical process of NMA using Stata software under frequentist framework. The NMA tries to synthesize evidences for a decision making by evaluating the comparative effectiveness of more than two alternative interventions for the same condition. Before conducting a NMA, 3 major assumptions-similarity, transitivity, and consistency-should be checked. The statistical analysis consists of 5 steps. The first step is to draw a network geometry to provide an overview of the network relationship. The second step checks the assumption of consistency. The third step is to make the network forest plot or interval plot in order to illustrate the summary size of comparative effectiveness among various interventions. The fourth step calculates cumulative rankings for identifying superiority among interventions. The last step evaluates publication bias or effect modifiers for a valid inference from results. The synthesized evidences through five steps would be very useful to evidence-based decision-making in healthcare. Thus, NMA should be activated in order to guarantee the quality of healthcare system.

Keywords: Biostatistic; Mixed treatment comparison; Network meta-analysis; Treatment outcome.

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Conflict of interest statement

The authors have no conflicts of interest to declare for this study.

Figures

Figure 1.
Figure 1.
Network geometry. When the obejctive is to examine comparative effectiveness of B-C among the treatments A, B, and C, a closed loop is present if research data comparing all 3 pairs (A-B, B-C, and A-C) exist.
Figure 2.
Figure 2.
Results of network setup order.
Figure 3.
Figure 3.
Results of test for inconsistency.
Figure 4.
Figure 4.
Network forest plot. A, placebo; B, IV_ single; C, IV_double; D, topical; E, combination.
Figure 5.
Figure 5.
Interval plot. CI, confidence interval.
Figure 6.
Figure 6.
Results of network rank test. A, placebo; B, IV_single; C, IV_double; D, topical; E, combination; SCURA, surface under the cumulative ranking.
See this image and copyright information in PMC

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