Epidemiol Health.  2017;39:e2017047. 10.4178/epih.e2017047.

Network meta-analysis: application and practice using Stata

Affiliations
  • 1Institute for Clinical Molecular Biology Research, Soonchunhyang University Hospital, Seoul, Korea.
  • 2Department of Orthopaedic Surgery, Seoul Paik Hospital, ,Inje University College of Medicine, Seoul, Korea.
  • 3Department of Education, Jeonju University, Jeonju, Korea.
  • 4Department of Preventive Medicine, Jeju National University School of Medicine, Jeju, Korea. jmbae@cheju.ac.kr

Abstract

This review aimed to arrange the concepts of a network meta-analysis (NMA) and to demonstrate the analytical process of NMA using Stata software under frequentist framework. The NMA tries to synthesize evidences for a decision making by evaluating the comparative effectiveness of more than two alternative interventions for the same condition. Before conducting a NMA, 3 major assumptions"”similarity, transitivity, and consistency"”should be checked. The statistical analysis consists of 5 steps. The first step is to draw a network geometry to provide an overview of the network relationship. The second step checks the assumption of consistency. The third step is to make the network forest plot or interval plot in order to illustrate the summary size of comparative effectiveness among various interventions. The fourth step calculates cumulative rankings for identifying superiority among interventions. The last step evaluates publication bias or effect modifiers for a valid inference from results. The synthesized evidences through five steps would be very useful to evidence-based decision-making in healthcare. Thus, NMA should be activated in order to guarantee the quality of healthcare system.

Keyword

Network meta-analysis; Treatment outcome; Mixed treatment comparison; Biostatistic

MeSH Terms

Decision Making
Delivery of Health Care
Forests
Publication Bias
Quality of Health Care
Treatment Outcome
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