Abstract：
OBJECTIVES:Network meta-analysis (NMA) may produce more precise estimates of treatment effects than pairwise meta-analysis. We examined the relative contribution of network paths of different lengths to estimates of treatment effects. STUDY DESIGN AND SETTING:We analyzed 213 published NMAs. We categorized network shapes according to the presence or absence of at least one closed loop (nonstar or star network) and derived the graph density, radius, and diameter. We identified paths of different lengths and calculated their percentage contribution to each NMA effect estimate, based on their contribution matrix. RESULTS:Among the 213 NMAs included in analyses, 33% of the information came from paths of length 1 (direct evidence), 47% from paths of length 2 (indirect paths with one intermediate treatment) and 20% from paths of length 3. The contribution of paths of different lengths depended on the size of networks, presence of closed loops, and graph radius, density, and diameter. Longer paths contribute more as the number of treatments and loops and the graph radius and diameter increase. CONCLUSION:The contribution of different paths depends on the size and structure of networks, with important implications for assessing the risk of bias and confidence in NMA results.
journal_name
J Clin Epidemioljournal_title
Journal of clinical epidemiologyauthors
Papakonstantinou T,Nikolakopoulou A,Egger M,Salanti Gdoi
10.1016/j.jclinepi.2020.04.009subject
Has Abstractpub_date
2020-08-01 00:00:00pages
42-49eissn
0895-4356issn
1878-5921pii
S0895-4356(19)31016-9journal_volume
124pub_type
杂志文章abstract：:Medicine has been dominated by uncontrolled data, often of unproven validity and insufficient to answer clinically important questions pertaining to individual patients. Controlled clinical trials, when designed and conducted rigorously, offer advantages over uncontrolled data, but they cannot be done for everything a...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(98)00042-0
更新日期：1998-08-01 00:00:00
abstract：:Studies predicting mortality after myocardial infarction (MI) usually rely on in-hospital data, and combine patients admitted for the first MI with recurrent MI patients. Since treatment decisions are often made or modified at the first outpatient clinic visit, this study was designed to evaluate the importance of pos...
journal_title：Journal of clinical epidemiology
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/s0895-4356(96)00221-1
更新日期：1996-11-01 00:00:00
abstract：:Core outcome sets (COSs) are agreed-on standardized sets of outcomes that should be minimally measured in all trials of a given disease. To enhance the uptake of COSs in trials, their generalizability should be increased by a change in the number and diversity of stakeholders involved in their development. Also, their...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2020.01.004
更新日期：2020-09-01 00:00:00
abstract：:This study investigates aspects of the reliability of the Maastricht criteria list for quality assessment in systematic reviews, and whether blinded reviewing is necessary to prevent review bias. We used the data set of 12 articles from a systematic review concerning the efficacy of balneotherapy in patients with arth...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00297-7
更新日期：1998-04-01 00:00:00
abstract：OBJECTIVES:To identify, describe, and map contemporary nutrition guidelines (NGs) from reviews that used the Appraisal of Guidelines, Research and Evaluation (AGREE) tool. STUDY DESIGN AND SETTING:We performed an overview of reviews that systematically assessed the quality of NGs using the AGREE tool. We searched MEDL...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2018.08.018
更新日期：2018-12-01 00:00:00
abstract：OBJECTIVES:New evidence continues to emerge and requires attention after the release of a clinical practice guideline (CPG). The objective of this article is to describe the Document Assessment and Review (DAR) strategy designed to ensue that the CPGs remain current and their quality maintained and to present the resul...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2014.06.013
更新日期：2014-12-01 00:00:00
abstract：:Results from pragmatic trials should reflect the comparative treatment effects encountered in patients in real-life clinical practice to guide treatment decisions. Therefore, pragmatic trials should focus on outcomes that are relevant to patients, clinical practice, and treatment choices. This sixth article in the ser...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2016.12.022
更新日期：2017-10-01 00:00:00
abstract：BACKGROUND AND OBJECTIVE:Hui and Walter developed a latent class approach to assess the accuracy of a diagnostic procedure when no reference test is available. Our objective was to compare sensitivity and specificity estimates obtained with this reference-free approach and standard approaches, and to examine how and wh...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2004.10.021
更新日期：2005-07-01 00:00:00
abstract：OBJECTIVE:To determine which simple index of overweight and obesity is the best discriminator of cardiovascular risk factors. STUDY DESIGN AND SETTING:This is a meta-analysis of published literature. MEDLINE was searched. Studies that used receiver-operating characteristics (ROC) curve analysis and published area unde...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.jclinepi.2007.08.012
更新日期：2008-07-01 00:00:00
abstract：OBJECTIVES:Interpretation of clinical research findings using the paradigm of null hypothesis significance testing has a number of limitations. These include arbitrary dichotomization of results, lack of incorporation of study power and prior probability, and the confusing use of conditional probability. This study aim...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2017.08.016
更新日期：2017-12-01 00:00:00
abstract：:Since the demonstration in the 1940s of foreign body induction of sarcomas in rodents, the safety of artificial implants in humans has been a matter of concern. In this study, we assess the risk for the development of breast sarcomas in women with silicone breast implants. Our analysis is based on the National Cancer ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(94)00210-h
更新日期：1995-04-01 00:00:00
abstract：:A key component in the evaluation of efficacy of a vaccine to protect against disease caused by an antigenically diverse infectious pathogen in a preventative vaccine trial is assessing how vaccine-induced protection depends on genotypic and phenotypic variations of the exposing pathogen. This assessment is made by co...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/s0895-4356(00)00258-4
更新日期：2001-01-01 00:00:00
abstract：:Comparison of psychosocial adjustment in women with breast cancer (BC) and women with benign breast problems (BBP) has been hampered by a failure to control for age differences between these groups, as well as a failure to assess positive psychosocial adaptation in addition to psychological distress. Age-matched women...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(96)00028-5
更新日期：1996-08-01 00:00:00
abstract：:Reliability testing was conducted on a survey instrument for a genetic epidemiological study of Parkinson's disease (PD). Information on demographics, medical history, places of residence, and occupations was collected. The instrument was administered to 11 pairs of siblings discordant for PD and then re-administered ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(00)00229-8
更新日期：2000-08-01 00:00:00
abstract：:Our objective was to describe distortion in outcome studies due to "frailty bias" or differential susceptibility to adverse health outcomes due to frailties but attributed to other factors. We linked an administrative database to survey data (n = 5934) containing functional, condition, and outcome measures. The diseas...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(99)00056-6
更新日期：1999-08-01 00:00:00
abstract：OBJECTIVES:To evaluate the effectiveness of pre-notification and pleading invitations in Web surveys by embedding a randomized controlled trial (RCT) in a Web-based survey. STUDY DESIGN AND SETTING:E-mail addresses of 569 authors of published maternal health research were randomized in a 2×2 factorial trial of a pre-n...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jclinepi.2010.06.001
更新日期：2011-05-01 00:00:00
abstract：:The duration of protection offered by Pap screening for cervical cancer was examined using data on 101 cases of invasive cervical cancer and 396 controls from a Maryland case-control study. Receipt of a Pap test up to 4 years ago afforded significant protection, compared to women screened 11 or more years ago, or neve...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(89)90166-2
更新日期：1989-01-01 00:00:00
abstract：:We assessed the relationship between characteristics of stroke victims and the risk of early death from coronary or cerebrovascular disease (CCVD) among their children. For each of 55 stroke patients selected from a registry which enrolled patients between 1969 and 1973, an index of their progeny's survival was calcul...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(90)90055-t
更新日期：1990-01-01 00:00:00
abstract：OBJECTIVES:To evaluate whether noninferiority trials are designed to adequately preserve the historical treatment effect of their active comparators. STUDY DESIGN AND SETTING:We reviewed 162 noninferiority trials published in high-impact medical journals. We assessed whether trials were designed to ensure that interve...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2019.03.003
更新日期：2019-06-01 00:00:00
abstract：OBJECTIVES:The aim of the study was to assess the completeness of reporting of methods in overviews. STUDY DESIGN AND SETTING:Assessment of the adequacy of reporting of methods in a random sample of 50 overviews was based on a published framework of methods for conducting overviews. Descriptive summary statistics were...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2019.09.025
更新日期：2020-02-01 00:00:00
abstract：:Educational attainment has been negatively associated with the prevalence, morbidity and mortality of many diseases. With knee osteoarthritis as an example, we used NHANES I data to examine whether the cross-sectional association between formal education and disease is due to known risk factors, and also whether educa...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(92)90006-9
更新日期：1992-02-01 00:00:00
abstract：OBJECTIVE:Statistical interaction between a single, instantaneous exposure and attained age (age during follow-up; attained age = age at exposure + time since exposure) is used in risk analyses to assess potential effect modification by unmeasured factors correlated with age. However, the impact of such interaction on ...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2015.10.004
更新日期：2016-03-01 00:00:00
abstract：OBJECTIVES:This study compares three major elements of evidence-based medicine (EBM) practices, namely evidence synthesis, clinical practice guidelines (CPGs), and real-world prescriptions in the United States, regarding antidepressant treatments of major depression over the past 3 decades. STUDY DESIGN AND SETTING:We...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2020.12.023
更新日期：2021-01-06 00:00:00
abstract：:From a database of 93,077 in-patient admissions, patients assigned to catastrophic, very severe, moderately severe, and average 30-day mortality risk categories (as defined in Medicare Hospital Mortality Information, 1989 release, from the Health Care Financing Administration (HCFA] were selected for study. These admi...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/0895-4356(91)90100-n
更新日期：1991-01-01 00:00:00
abstract：:To compare Charlson indices based on chart data and ICD-9 data for agreement overall and on rating specific comorbid conditions, and to compare mortality risks associated with these indices. Prospective cohort study. Six general medicine wards at Yale-New Haven Hospital. 524 consecutive patients who had no clinical ev...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(00)00367-x
更新日期：2001-07-01 00:00:00
abstract：OBJECTIVES:To assess whether the reported trial characteristics are associated with treatment effects on all-cause mortality within critical care medicine. STUDY DESIGN AND SETTING:We identified all eligible randomized controlled trials (RCTs) from Cochrane Reviews on patients with sepsis, septic shock, and cardiogeni...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,评审
doi：10.1016/j.jclinepi.2013.05.016
更新日期：2013-11-01 00:00:00
abstract：OBJECTIVES:Meta-analyses inform clinical practice by summarizing treatment effect estimates based on results from several trials. However, the statistical significance of a meta-analysis (i.e., whether the pooled treatment effect is statistically significant or not) may rely on the outcome of only a few patients from s...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2019.03.012
更新日期：2019-07-01 00:00:00
abstract：OBJECTIVE:The use of then-test (retrospective pre-test) scores has frequently been proposed as a solution to potential confounding of change scores because of response shift, as it is assumed that then-test and post-test responses are provided from the same perspective. However, this assumption has not been formally te...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jclinepi.2009.01.021
更新日期：2009-11-01 00:00:00
abstract：OBJECTIVES:In a twinning partnership between the Canadian Society for International Health and Kazakhstan's Ministry of Health, a project to build capacity and a process for the adaptation and implementation of international clinical practice guidelines (CPGs) was undertaken. STUDY DESIGN AND SETTING:A pragmatic CPG a...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/j.jclinepi.2015.05.001
更新日期：2016-01-01 00:00:00
abstract：:We assessed the performance of diagnostic electrocardiogram (ECG) interpretation by the computer program MEANS and by research physicians, compared to cardiologists, in a physician-based study. To establish a strategy for ECG interpretation in health surveys, we also studied the diagnostic capacity of three scenarios:...
journal_title：Journal of clinical epidemiology
pub_type： 杂志文章
doi：10.1016/s0895-4356(97)00100-5
更新日期：1997-08-01 00:00:00
