A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis
BMJ2014Vol. 349(sep24 5), pp. g5630–g5630
Citations Over TimeTop 1% of 2014 papers
Milo A. Puhan, Holger J. Schünemann, M. Hassan Murad, Tianjing Li, Romina Brignardello‐Petersen, Jasvinder A. Singh, A. G. H. Kessels, Gordon Guyatt, for the GRADE Working Group
Abstract
Network meta-analysis (NMA), combining direct and indirect comparisons, is increasingly being used to examine the comparative effectiveness of medical interventions. Minimal guidance exists on how to rate the quality of evidence supporting treatment effect estimates obtained from NMA. We present a four-step approach to rate the quality of evidence in each of the direct, indirect, and NMA estimates based on methods developed by the GRADE working group. Using an example of a published NMA, we show that the quality of evidence supporting NMA estimates varies from high to very low across comparisons, and that quality ratings given to a whole network are uninformative and likely to mislead.
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