CINeMA: An approach for assessing confidence in the results of a network meta-analysis
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Open Access
- 3 April 2020
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLoS Medicine
- Vol. 17 (4), e1003082
- https://doi.org/10.1371/journal.pmed.1003082
Abstract
The evaluation of the credibility of results from a meta-analysis has become an important part of the evidence synthesis process. We present a methodological framework to evaluate confidence in the results from network meta-analyses, Confidence in Network Meta-Analysis (CINeMA), when multiple interventions are compared. CINeMA considers 6 domains: (i) within-study bias, (ii) reporting bias, (iii) indirectness, (iv) imprecision, (v) heterogeneity, and (vi) incoherence. Key to judgments about within-study bias and indirectness is the percentage contribution matrix, which shows how much information each study contributes to the results from network meta-analysis. The contribution matrix can easily be computed using a freely available web application. In evaluating imprecision, heterogeneity, and incoherence, we consider the impact of these components of variability in forming clinical decisions. Via 3 examples, we show that CINeMA improves transparency and avoids the selective use of evidence when forming judgments, thus limiting subjectivity in the process. CINeMA is easy to apply even in large and complicated networks.Keywords
Funding Information
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (179158)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (174281)
- Campbell Collaboration
- Cochrane Collaboration
This publication has 60 references indexed in Scilit:
- Evidence Synthesis for Decision Making 7Medical Decision Making, 2013
- Evidence Synthesis for Decision Making 4Medical Decision Making, 2013
- Evidence Synthesis for Decision Making 2Medical Decision Making, 2012
- Simulation evaluation of statistical properties of methods for indirect and mixed treatment comparisonsBMC Medical Research Methodology, 2012
- Systematic review and mixed treatment comparison: dressings to heal diabetic foot ulcersDiabetologia, 2012
- Predicting the extent of heterogeneity in meta-analysis, using empirical data from the Cochrane Database of Systematic ReviewsInternational Journal of Epidemiology, 2012
- The Cochrane Collaboration's tool for assessing risk of bias in randomised trialsBMJ, 2011
- GRADE: an emerging consensus on rating quality of evidence and strength of recommendationsBMJ, 2008
- Selective Publication of Antidepressant Trials and Its Influence on Apparent EfficacyThe New England Journal of Medicine, 2008
- Full publication of results initially presented in abstractsEmergencias, 2007