Importance of assessing and adjusting for cross-study heterogeneity in network meta-analysis: a case study of psoriasis.

Abstract:

AIM:The importance of adjusting for cross-study heterogeneity when conducting network meta-analyses (NMAs) was demonstrated using a case study of biologic therapies for moderate-to-severe plaque psoriasis. METHODS:Bayesian NMAs were conducted for Psoriasis Area and Severity Index 90 response. Several covariates were considered to account for cross-trial differences: baseline risk (i.e., placebo response), prior biologic use, body weight, psoriasis duration, age, race and baseline Psoriasis Area and Severity Index score. Model fit was evaluated. RESULTS:The baseline risk-adjusted NMA, which adjusts for multiple observed and unobserved effect modifiers, was associated with the best model fit. Lack of adjustment for cross-trial differences led to different clinical interpretations of findings. CONCLUSION:Failure to adjust for cross-trial differences in NMA can have important implications for clinical interpretations when studying the comparative efficacy of healthcare interventions.

journal_name

J Comp Eff Res

authors

Cameron C,Hutton B,Druchok C,McElligott S,Nair S,Schubert A,Situ A,Varu A,Villacorta R

doi

10.2217/cer-2018-0065

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

1037-1051

issue

11

eissn

2042-6305

issn

2042-6313

journal_volume

7

pub_type

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