Using the contribution matrix to evaluate complex study limitations in a network meta-analysis: a case study of bipolar maintenance pharmacotherapy review.

Furukawa, Toshi A; Miura, Tomofumi; Chaimani, Anna; Leucht, Stefan; Cipriani, Andrea; Noma, Hisashi; Mitsuyasu, Hiroshi; Kanba, Shegenobu; Salanti, Georgia (2016). Using the contribution matrix to evaluate complex study limitations in a network meta-analysis: a case study of bipolar maintenance pharmacotherapy review. BMC research notes, 9(1), p. 218. Biomed Central 10.1186/s13104-016-2019-1

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BACKGROUND Limitations in the primary studies constitute one important factor to be considered in the grading of recommendations assessment, development, and evaluation (GRADE) system of rating quality of evidence. However, in the network meta-analysis (NMA), such evaluation poses a special challenge because each network estimate receives different amounts of contributions from various studies via direct as well as indirect routes and because some biases have directions whose repercussion in the network can be complicated. FINDINGS In this report we use the NMA of maintenance pharmacotherapy of bipolar disorder (17 interventions, 33 studies) and demonstrate how to quantitatively evaluate the impact of study limitations using netweight, a STATA command for NMA. For each network estimate, the percentage of contributions from direct comparisons at high, moderate or low risk of bias were quantified, respectively. This method has proven flexible enough to accommodate complex biases with direction, such as the one due to the enrichment design seen in some trials of bipolar maintenance pharmacotherapy. CONCLUSIONS Using netweight, therefore, we can evaluate in a transparent and quantitative manner how study limitations of individual studies in the NMA impact on the quality of evidence of each network estimate, even when such limitations have clear directions.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Salanti, Georgia

Subjects:

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

ISSN:

1756-0500

Publisher:

Biomed Central

Language:

English

Submitter:

Beatrice Minder Wyssmann

Date Deposited:

18 Apr 2016 10:57

Last Modified:

09 May 2016 16:51

Publisher DOI:

10.1186/s13104-016-2019-1

PubMed ID:

27074861

Uncontrolled Keywords:

Enrichment design; GRADE Network meta-analysis; Risk of bias; Study limitations

BORIS DOI:

10.7892/boris.81194

URI:

https://boris.unibe.ch/id/eprint/81194

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