Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Aug:124:94-105.
doi: 10.1016/j.jclinepi.2020.05.010. Epub 2020 May 12.

Uptake of methodological advances for synthesis of continuous and time-to-event outcomes would maximize use of the evidence base

Suzanne C Freeman  1 , Alex J Sutton  2 , Nicola J Cooper  2
Affiliations
Review

Uptake of methodological advances for synthesis of continuous and time-to-event outcomes would maximize use of the evidence base

Suzanne C Freeman et al. J Clin Epidemiol. 2020 Aug.

Abstract

Objective: The objective of the study is to establish how often continuous and time-to-event outcomes are synthesized in health technology assessment (HTA), the statistical methods and software used in their analysis and how often evidence synthesis informs decision models.

Study design and setting: This is a review of National Institute of Health Research HTA reports, National Institute for Health and Care Excellence (NICE) technology appraisals, and NICE guidelines reporting quantitative meta-analysis or network meta-analysis of at least one continuous or time-to-event outcome published from April 01, 2018 to March 31, 2019.

Results: We identified 47 eligible articles. At least one continuous or time-to-event outcome was synthesized in 51% and 55% of articles, respectively. Evidence synthesis results informed decision models in two-thirds of articles. The review and expert knowledge identified five areas where methodology is available for improving the synthesis of continuous and time-to-event outcomes: i) outcomes reported on multiple scales, ii) reporting of multiple related outcomes, iii) appropriateness of the additive scale, iv) reporting of multiple time points, and v) nonproportional hazards. We identified three anticipated barriers to the uptake and implementation of these methods: i) statistical expertise, ii) software, and iii) reporting of trials.

Conclusion: Continuous and time-to-event outcomes are routinely reported in HTA. However, increased uptake of methodological advances could maximize the evidence base used to inform the decision making process.

Keywords: Clinical decision-making; Continuous outcomes; Decision models; Evidence synthesis; Health technology assessment; Time-to-event outcomes.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart of article selection process. HTA, health technology assessment; NICE, National Institute for Health and Care Excellence; NIHR, National Institute for Health Research.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cooper N., Sutton A., Achana F., Welton N. Canadian Agency for Drugs and Technologies in Health; Ottawa: 2016. Use of network meta-analysis to inform clinical parameters in economic evaluations.
    1. Lumley T. Network meta-analysis for indirect treatment comparisons. Stat Med. 2002;21:2313–2324. - PubMed
    1. Caldwell D., Ades A., Higgins J. Simultaneous comparison of multiple treatments: combining direct and indirect evidence. BMJ. 2005;331:897–900. - PMC - PubMed
    1. Salanti G. Indirect and mixed-treatment comparison, network, or multiple-treatments meta-analysis: many names, many benefits, many concerns for the next generation evidence synthesis tool. Res Synth Methods. 2012;3(2):80–97. - PubMed
    1. National Institute of Health and Care Excellence Guide to the methods of technology appraisal 2004. 2004. https://webarchive.nationalarchives.gov.uk/20080611223138/http://www.nic... Available at. - PubMed

Publication types

MeSH terms