Leonardo Roever1*, Elmiro Santos Resende1, and Giuseppe Biondi-Zoccai2,3,4
Federal University of Uberlândia, Department of Clinical Research, Brazil
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
Eleonora Lorillard Spencer Cenci Foundation, Rome, Italy
VCU Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
Corresponding Author:
Leonardo S Roever-Borges
Federal University of Uberlândia
Department of Clinical Research
Bairro Umuarama, Uberlândia, Brazil
Tel: 553488039878
E-mail: leonardoroever@hotmail.com
Introduction
Clinical decision-making depends on a balanced judgment between the resources, tasks, skills and values, which in several times depends on external factors that cannot be easily controlled. Network meta-analysis is used to include all methods of synthesis that is extensive evidence, indirect comparison set, the comparison treatment mixture, and processing multiple meta-analysis [1-13] (Table 1).
Network meta-analysis in intensive and critical care |
Advanced Topics |
Future Perspectives |
Incorporating moderators: network meta-regression
Appraising between-study heterogeneity
Appraising inconsistency between direct and indirect estimates
Appraising small study effects and publication bias
Combining multiple effect estimates: multivariate network meta-analysis
Moving from study-level to patient-level data: individual patient network meta-analysis
State of the art reporting of network meta-analyses |
Moving from evidence synthesis to action The future of network meta-analysis: toward accessibility and integration |
Table 1 Describes the advanced topics and future perspectives of the network meta-analysis in intensive and critical care.
The future of network meta-analysis depends on the process of conducting a valid and effective systematic review, as well as the successful implementation of decision makers. This can provide new solutions to complex problems, from the evidence available to guide a more accurate clinical practice.
References
- Greco T, Biondi-Zoccai G, Saleh O, Pasin L, Cabrini L, et. al. (2015)The attractiveness of network meta-analysis: a comprehensive systematic and narrative review. Heart, Lung and Vessels 7: 133-142.
- Biondi-Zoccai G, Abbate A, Benedetto U, Palmerini T, D'Ascenzo F, et al. (2015) Network meta-analysis for evidence synthesis: What is it and why is it posed to dominate cardiovascular decision making? International Journal of Cardiology 182: 309-314.
- Guyatt G, Meade MO, Cook DJ, Rennie D (2014) Users' Guides to the Medical Literature: A Manual for Evidence-based Clinical Practice. (Third edition), McGrawHill Companies, New York.
- Stolker JM, Spertus JA, Cohen DJ, Jones PG, Jain KK (2014) Rethinking composite endpoints in clinical trials: insights from patients and trialists. Circulation 130: 1254-1261.
- Biondi-Zoccai G (2014) Network Meta-analysis: Evidence Synthesis with Mixed Treatment Comparison. Nova Science Publishers, New York.
- Palmerini T, Biondi-Zoccai G, Riva DD, Mariani A, Savini C, et al. (2013) Risk of stroke with percutaneous coronary intervention compared with on-pump and off-pump coronary artery bypass graft surgery: evidence from a comprehensive network meta-analysis.Am Heart J 165: 910-917.
- Norton EC, Miller MM, Wang JJ, Coyne K, Kleinman LC (2008) Rank reversal in indirect comparisons. Value Health 15: 1137-1140.
- Higgins JPT, Green S (2008) Cochrane Handbook for Systematic Reviews of Interventions. John Wiley & Sons, Chichester.
- Palmerini T, Biondi-Zoccai G, RivaDella D, Stettler C, Sangiorgi D (2012) Stent thrombosis with drug eluting and bare-metal stents: evidence from a comprehensive network meta-analysis. Lancet 379: 1393-1402.
- Biondi-Zoccai GG, Lotrionte M, Anselmino M, Moretti C, Agostoni P (2008) Systematic review and metaanalysis of randomized clinical trials appraising the impact of cilostazol after percutaneous coronary intervention. Am. Heart J. 155: 1081-1089.
- Mavridis D, Sutton A, Cipriani A, Salanti G (2013) A fully Bayesian application of the Copas selection model for publication bias extended to network meta-analysis. Stat. Med. 32: 51-66.
- Stolker JM, Spertus JA, Cohen DJ, Jones PG, Jain KK (2014) Rethinking composite endpoints in clinical trials: insights from patients and trialists. Circulation 130: 1254-1261.
- PP Glasziou, I Chalmers, S Green, S Michie (2014) Intervention synthesis: a missing link between a systematic review and practical treatment(s). PLoS Med 11: e1001690.