Extensions of the probabilistic ranking metrics of competing treatments in network meta-analysis to reflect clinically important relative differences on many outcomes.

Mavridis, Dimitris; Porcher, Raphaël; Nikolakopoulou, Adriani; Salanti, Georgia; Ravaud, Philippe (2020). Extensions of the probabilistic ranking metrics of competing treatments in network meta-analysis to reflect clinically important relative differences on many outcomes. Biometrical journal, 62(2), pp. 375-385. Wiley-VCH 10.1002/bimj.201900026

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One of the key features of network meta-analysis is ranking of interventions according to outcomes of interest. Ranking metrics are prone to misinterpretation because of two limitations associated with the current ranking methods. First, differences in relative treatment effects might not be clinically important and this is not reflected in the ranking metrics. Second, there are no established methods to include several health outcomes in the ranking assessments. To address these two issues, we extended the P-score method to allow for multiple outcomes and modified it to measure the mean extent of certainty that a treatment is better than the competing treatments by a certain amount, for example, the minimum clinical important difference. We suggest to present the tradeoff between beneficial and harmful outcomes allowing stakeholders to consider how much adverse effect they are willing to tolerate for specific gains in efficacy. We used a published network of 212 trials comparing 15 antipsychotics and placebo using a random effects network meta-analysis model, focusing on three outcomes; reduction in symptoms of schizophrenia in a standardized scale, all-cause discontinuation, and weight gain.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Nikolakopoulou, Adriani and Salanti, Georgia

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0323-3847

Publisher:

Wiley-VCH

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Andrea Flükiger-Flückiger

Date Deposited:

06 Nov 2019 15:54

Last Modified:

04 Mar 2020 01:31

Publisher DOI:

10.1002/bimj.201900026

PubMed ID:

31661561

Additional Information:

Salanti and Ravaud contributed equally to this work (joint last authors).

Uncontrolled Keywords:

benefit-risk assessment clinically important value multiple outcomes network meta-analysis ranking metrics

BORIS DOI:

10.7892/boris.134581

URI:

https://boris.unibe.ch/id/eprint/134581

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