Version 1 introduced the quality effects qe model, version 2 the inverse variance heterogeneity ivhet model, version 3 introduced the doi plot and lfk index for the detection of publication bias, version 4 added network metaanalysis. Bayesian inference using gibbs sampling to conduct. In metaregression, we established that there is a negative association between the magnitudes of effect sizes and the amount of prior teacherstudent contact weeks. Research synthesis methods, 3, 16176 dias s, welton nj, caldwell dm, ades ae 2010. Chapter 11 network metaanalysis doing metaanalysis in r. Mar 16, 2019 network meta analysis nma is an advanced technique in that it allows both direct comparisons as does pairwise meta analysis, but also indirect comparisons for treatments that have not been made in a headtohead format, and is recommended when competing interventions are used 20,21,22,23,24,25. Apr 08, 2019 the objective of this study is to describe the general approaches to network meta analysis that are available for quantitative data synthesis using r software. Network metaanalysis nma comparing multiple treatments by using both direct comparisons of interventions within randomized controlled trials and indirect comparisons across trials based on a common comparator. Care needs to be taken using this method because it is more statistically complex than a standard meta analysis. Software for bayesian network metaanalyses quantics biostatistics. Comparisons of exacerbations and mortality among regular. Network metaanalysis for decisionmaking statistics in. Network metaanalysis of randomised trials of pharmacological. Lu and ades proposed the first bayesian network metaanalysis models in 2004 their paper was accompanied by winbugs code 1.
Key concepts in network meta analysis nma the following two videos will introduce you to the key concepts in network meta analysis nma. Network meta analysis for decisionmaking takes an approach to evidence synthesis that is specifically intended for decision making when there are two or more treatment alternatives being evaluated, and assumes that the purpose of every synthesis is to answer the question for this preidentified population of patients, which treatment is best. Any nma treatments consisting of strictly unclosed loops can be thought of as a series of itcs. Many combinations of direct or indirect interactions. While the work presented within this paper provides the essential tools required to conduct an nma in accordance with current guidelines, we plan to implement additional functions and features within this package, based on user feedback. We conducted a network meta analysis using two approaches. Network metaanalysis cochrane comparing multiple interventions. Software and package applicating for network metaanalysis. Meta analysis and network meta analysis are only as good as the studies they are based on. It has usually been performed in a bayesian setting, but recently it has become possible in a frequentist setting using multivariate meta analysis and meta regression, implemented in stata. In addition, prior distributions have to be specified for a number of the parameters, and the data have to be supplied in a specific format. Official meta analysis commands are available in stata 16. Network metaanalysis nma, also called multiple treatment metaanalysis, or mixed treatment comparison, aims to synthesize the effect sizes of several studies that evaluate multiple interventions or treatments 14.
In the following, we will describe how to perform a network meta analysis based on a bayesian hierarchical framework. We can perform cumulative metaanalysis to explore the trend in the effect sizes as a function of weeks. The winbugs software can be called from either r provided r2winbugs as an r package or stata software for network meta analysis. The network graphs package visualizing assumptions and results in network metaanalysis although network metaanalysis has been established as a useful evidence synthesis tool it has been often criticized for its complexity and for been accessible only to researchers with strong statistical and computational skills. Often when performing a meta analysis on the effectiveness of certain interventions, we are less interested in the question if one particular intervention is effective e. Network meta analysis synthesizes direct and indirect evidence in a network of trials that compare multiple interventions and has the potential to rank the competing treatments according to the studied outcome. Key concepts in network metaanalysis nma the following two videos will introduce you to the key concepts in network metaanalysis nma. If you use it, please kindly cite the articles that describe them. In the conventional pairwise metaanalysis, the researchers collect studies that evaluate the same treatment, create pairs of the treatment group and control group. Read 146 answers by scientists with 234 recommendations from their colleagues to the question asked by aref bin abdulhak on jan 16, 20. Free example apply what youve learned discussion 1. The first video is a brief 10 min, nontechnical introduction recorded in 2016 by georgia salanti from institute of social and preventive medicine, university of bern, switzerland, and university of ioannina school of medicine, ioannina, greece. The software automatically generates models for network metaanalysis suitable for mcmc software, like winbugs, openbugs and jags.
In estimating a network meta analysis model using a bayesian framework, the rjags package is a common tool. Which network metaanalysis software is free to download. Running a network metaanalysis using winbugs youtube. The use of network meta analysis has increased dramatically in recent years. A practical guide to network meta analysis with examples and code in the evaluation of healthcare, rigorous methods of quantitative assessment are necessary to establish which interventions are effective and costeffective. Network metaanalysis nma or mixed treatment comparisonmetaanalyses mtc or mtm these terms, which are often used interchangeably, refer to situations involving the simultaneous comparison of three or more interventions. We hope you will find the software presented useful. A network metaanalysis nma toolkit cochrane training. The winbugs software can be called from either r provided r2winbugs as an r package or stata software for network metaanalysis. Cochrane comparing multiple intervention methods group compiled a suite of online materials and software tools for conducting network metaanalysis. Nov 15, 2017 these include fixed and random effects analysis, fixed and mixed effects meta regression, forest and funnel plots, tests for funnel plot asymmetry, trimandfill and failsafe n analysis, and more. A network metaanalysis toolkit cochrane comparing multiple. Winbugs, a freely available bayesian software package, has been the most widely used software package to conduct network meta analyses. The network graphs package visualizing assumptions and results in network meta analysis although network meta analysis has been established as a useful evidence synthesis tool it has been often criticized for its complexity and for been accessible only to researchers with strong statistical and computational skills.
Sep 29, 2014 the use of network meta analysis has increased dramatically in recent years. Using stata for standard pairwise and network meta analysis. It is based on a methodological framework described in 1 which considers six domains. Often when performing a metaanalysis on the effectiveness of certain interventions, we are less interested in the question if one particular intervention is effective e. However, the learning curve for winbugs can be daunting, especially for new users. The additional semantics of causal networks specify that if a node x is actively caused to be in a given state x an action written as do x x, then the probability density function changes to that of the network obtained by cutting the links from.
If you use the stata routines please kindly cite the articles that describe them. Software for bayesian network metaanalyses quantics. An introduction to network metaanalysis mixed treatment. Cinema confidence in network meta analysis is a web application that simplifies the evaluation of confidence in the findings from network meta analysis. Despite its usefulness network meta analysis is often criticized for its complexity and for being accessible only to researchers with strong statistical and computational skills. A microsoftexcelbased tool for running and critically. Network meta analysis combines direct and indirect estimates across a network of interventions in a single analysis and can inform comparative effectiveness of multiple interventions. For individual studies, important considerations include how patients were randomized to the treatments, whether both patients and outcome assessors were blind to the treatment and how missing data were handled. There are few free software for network metaanalysis and are easy to use. Using network meta analysis to evaluate the existence of smallstudy effects in a network of interventions.
We hope you will find the material presented useful. Stata software for pairwise and network metaanalysis. Stata 16 contains a suite of commands for performing meta analysis. Petticrew et al 20 network meta analyses are best designed for. The estimated overall effect sizes, test for heterogeneity, moderator effects, and publication bias were reported using r software. Network meta analysis is a popular way to combine results from several studies usually randomized trials comparing several treatments or interventions. Often a single study will not provide the answers and it is desirable to synthesise evidence from multiple sources, usually randomised controlled trials. Specifying a bayesian network meta analysis model involves writing a directed acyclic graph dag model for generalpurpose markov chain monte carlo mcmc software such as winbugs. Stata software for pairwise and network metaanalysis methods team.
May 21, 2020 network meta analysis compares multiple interventions simultaneously by analyzing studies making different comparisons in the same analysis. Multipletreatments meta analysis a framework for evaluating and ranking multiple healthcare technologies. We need a software to perform network metanalysis and mixed indirect comparisons. The gemtc software can be used either via a gui graphical user interface application or via r. Here we focus on one example, providing the equivalent stan code for program number 7 b in the nice dsu tsd 2 pg 95, which consists of a fixed effect model for a normally distributed continuous outcome. A causal network is a bayesian network with the requirement that the relationships be causal. Metaxl keeps pushing the envelope of innovation in metaanalysis. Which software can create a network metaanalysis for free. Network metaanalysis nma, also termed multiple treatment metaanalysis or mixed treatment comparisons, was developed as an extension of pairwise metaanalysis to allow comparisons of more than two interventions in a single, coherent analysis of all the relevant rcts. Network metaanalysis compares multiple interventions simultaneously by. Furthermore, critical appraisal of network meta analyses conducted in winbugs can be challenging.
Unlike r, stata software needs to create relevant ado scripts at. The number of publications using network meta analysis nma has increased dramatically within the past decade. Assessing the feasibility of conducting a network meta analysis. Which network metaanalysis software is free to download and easy to use. The r package we will use to do this is the gemtc package valkenhoef et al. The engine behind this analysis power is the software developed in the metaforproject. The software automatically generates models for network meta analysis suitable for mcmc software, like winbugs, openbugs and jags. Which metaanalysis software is easy to use researchgate. The first video is a brief 10 min, nontechnical introduction recorded in 2016 by georgia salanti from institute of social and preventive medicine, university of bern, switzerland, and university of. Jun 02, 2012 step by step instructions on how to run a network meta analysis using winbugs.
What is the easiest software to make a network metaanalysis using. Which software can create a network metaanalysis for free download or the command for the indirect comparison for stata. In order to explore the use of stan for network meta analysis, we reprogrammed the winbugs models from the nice dsu tsd 2 in stan. Indirect treatment comparisons itc and network metaanalysis.