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Open Access Highly Accessed Research article

Network-meta analysis made easy: detection of inconsistency using factorial analysis-of-variance models

Hans-Peter Piepho

Author Affiliations

Bioinformatics Unit, Institute of Crop Science, University of Hohenheim, Fruwirthstrasse 23, 70599 Stuttgart, Germany

BMC Medical Research Methodology 2014, 14:61  doi:10.1186/1471-2288-14-61

Published: 10 May 2014

Abstract

Background

Network meta-analysis can be used to combine results from several randomized trials involving more than two treatments. Potential inconsistency among different types of trial (designs) differing in the set of treatments tested is a major challenge, and application of procedures for detecting and locating inconsistency in trial networks is a key step in the conduct of such analyses.

Methods

Network meta-analysis can be very conveniently performed using factorial analysis-of-variance methods. Inconsistency can be scrutinized by inspecting the design × treatment interaction. This approach is in many ways simpler to implement than the more common approach of using treatment-versus-control contrasts.

Results

We show that standard regression diagnostics available in common linear mixed model packages can be used to detect and locate inconsistency in trial networks. Moreover, a suitable definition of factors and effects allows devising significance tests for inconsistency.

Conclusion

Factorial analysis of variance provides a convenient framework for conducting network meta-analysis, including diagnostic checks for inconsistency.

Keywords:
Analysis of variance; Baseline contrast; Heterogeneity; Inconsistency; Linear mixed model; Network meta-analysis; Pairwise treatment contrast; PRESS residual; Studentized residual