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Sensitivity of treatment recommendations to bias in network meta‐analysis

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  • David M. Phillippo
  • Sofia Dias
  • A. E. Ades
  • Vanessa Didelez
  • Nicky J. Welton

Abstract

Network meta‐analysis (NMA) pools evidence on multiple treatments to estimate relative treatment effects. Included studies are typically assessed for risk of bias; however, this provides no indication of the impact of potential bias on a decision based on the NMA. We propose methods to derive bias adjustment thresholds which measure the smallest changes to the data that result in a change of treatment decision. The methods use efficient matrix operations and can be applied to explore the consequences of bias in individual studies or aggregate treatment contrasts, in both fixed and random‐effects NMA models. Complex models with multiple types of data input are handled by using an approximation to the hypothetical aggregate likelihood. The methods are illustrated with a simple NMA of thrombolytic treatments and a more complex example comparing social anxiety interventions. An accompanying R package is provided.

Suggested Citation

  • David M. Phillippo & Sofia Dias & A. E. Ades & Vanessa Didelez & Nicky J. Welton, 2018. "Sensitivity of treatment recommendations to bias in network meta‐analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 181(3), pages 843-867, June.
    • Handle: RePEc:bla:jorssa:v:181:y:2018:i:3:p:843-867
    DOI: 10.1111/rssa.12341
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    References listed on IDEAS

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    1. Lu, Guobing & Ades, A.E., 2006. "Assessing Evidence Inconsistency in Mixed Treatment Comparisons," Journal of the American Statistical Association, American Statistical Association, vol. 101, pages 447-459, June.
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    3. Naci, Huseyin & Dias, Sofia & Ades, A. E., 2014. "Industry sponsorship bias in research findings: a network meta-analysis of LDL cholesterol reduction in randomised trials of statins," LSE Research Online Documents on Economics 59798, London School of Economics and Political Science, LSE Library.
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    6. S. Dias & N. J. Welton & V. C. C. Marinho & G. Salanti & J. P. T. Higgins & A. E. Ades, 2010. "Estimation and adjustment of bias in randomized evidence by using mixed treatment comparison meta‐analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 173(3), pages 613-629, July.
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    Cited by:

    1. K. M. Rhodes & J. Savović & R. Elbers & H. E. Jones & J. P. T. Higgins & J. A. C. Sterne & N. J. Welton & R. M. Turner, 2020. "Adjusting trial results for biases in meta‐analysis: combining data‐based evidence on bias with detailed trial assessment," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 183(1), pages 193-209, January.

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