The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.Ī network meta-analysis produces inferences regarding the relative effectiveness or safety of multiple treatments –. The views expressed in this article are those of the authors and not necessarily those of The Cochrane Collaboration or its registered entities, committees, or working groups.
This research was also supported in part by The Cochrane Collaboration’s Methods Innovation Funding programme. DC was supported by a Medical Research Council Population Health Scientist fellowship award (grant no. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.įunding: GS and AC received funding from the European Research Council (IMMA, grant no. Received: JanuAccepted: Published: July 3, 2014Ĭopyright: © 2014 Salanti et al. PLoS ONE 9(7):Įditor: Yu-Kang Tu, National Taiwan University, Taiwan Judgements about evidence from a network meta-analysis can be different from those made about evidence from pairwise meta-analyses.Ĭitation: Salanti G, Del Giovane C, Chaimani A, Caldwell DM, Higgins JPT (2014) Evaluating the Quality of Evidence from a Network Meta-Analysis. The proposed framework can be used to determine confidence in the results from a network meta-analysis. We apply our proposed strategy to a systematic review comparing topical antibiotics without steroids for chronically discharging ears with underlying eardrum perforations. The suggested framework for evaluating a network meta-analysis acknowledges (i) the key role of indirect comparisons (ii) the contributions of each piece of direct evidence to the network meta-analysis estimates of effect size (iii) the importance of the transitivity assumption to the validity of network meta-analysis and (iv) the possibility of disagreement between direct evidence and indirect evidence. Our proposed approach is based on methodology developed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group for pairwise meta-analyses.
We propose an approach to determining confidence in the output of a network meta-analysis. It is important to consider the confidence with which these two types of results can enable clinicians, policy makers and patients to make informed decisions.
A network meta-analysis provides two types of findings for a specific outcome: the relative treatment effect for all pairwise comparisons, and a ranking of the treatments. Systematic reviews that collate data about the relative effects of multiple interventions via network meta-analysis are highly informative for decision-making purposes.
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