Deficiencies in addressing effect modification in network meta-analyses: A meta-epidemiological survey

Abstract Objective To evaluate the current state of reporting and handling of effect modification in network meta-analyses (NMAs), as well as perform exploratory analyses to identify variables that are potentially associated with incomplete reporting of effect modifiers in NMAs. Study Design and Set...

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Bibliographic Details
Published in:Journal of clinical epidemiology 2017-08, Vol.88, p.47-56
Main Authors: Kovic, Bruno, PhD Candidate, Zoratti, Michael J, Michalopoulos, Steven, Silvestre, Camila, H.B.Sc. Student, Thorlund, Kristian, Thabane, Lehana
Format: Article
Language:English
Subjects:
Clinical trials
Decision making
Design modifications
Effect modifier
Effect Modifier, Epidemiologic
Epidemiologic Studies
Epidemiology
Heterogeneity
Humans
Impact factors
Indirect treatment comparisons
Internal Medicine
International organizations
Journal Impact Factor
Meta-analysis
Meta-epidemiological survey
Methodology
Network Meta-Analysis
Randomization
Regression analysis
Sensitivity analysis
Statistical analysis
Systematic literature review
Task forces
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Summary:Abstract Objective To evaluate the current state of reporting and handling of effect modification in network meta-analyses (NMAs), as well as perform exploratory analyses to identify variables that are potentially associated with incomplete reporting of effect modifiers in NMAs. Study Design and Setting We conducted a meta-epidemiological survey utilizing a systematic review of NMAs published in 2013 and identified through MEDLINE and Embase databases. Results The review identified 77 NMAs. The most common type of effect modifiers identified and explored were patient characteristics (50.7% or 39/77), and most common adjustment method used was sensitivity analysis (51.7% or 30/58). Over 45% (35/77) of studies did not describe a plan, nearly 40% (30/77) did not report the results of analyses, and approximately 47% (36/77) of studies had incomplete reporting. Exploratory univariate regression analyses yielded a statistically significant association for the variables of journal impact factor, ratio of randomized controlled trials to number of comparisons, and total number of randomized controlled trials. Conclusion Current reporting practices are largely deficient, given that almost half of identified published NMAs do not explore or report effect modification. Journal impact factor and amount of available information in a network were associated with completeness of reporting.
ISSN:0895-4356
1878-5921
DOI:10.1016/j.jclinepi.2017.06.004