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Open Access Commentary

Network meta-analysis-highly attractive but more methodological research is needed

Tianjing Li1, Milo A Puhan1, Swaroop S Vedula1, Sonal Singh2, Kay Dickersin1* and The Ad Hoc Network Meta-analysis Methods Meeting Working Group

Author Affiliations

1 Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Mail Room W5010, Baltimore, Maryland, 21212, USA

2 Johns Hopkins Medical Institutions, 1830 E. Monument St, Suite 8063, Baltimore, Maryland, 21212, USA

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BMC Medicine 2011, 9:79  doi:10.1186/1741-7015-9-79

Published: 27 June 2011

Abstract

Network meta-analysis, in the context of a systematic review, is a meta-analysis in which multiple treatments (that is, three or more) are being compared using both direct comparisons of interventions within randomized controlled trials and indirect comparisons across trials based on a common comparator. To ensure validity of findings from network meta-analyses, the systematic review must be designed rigorously and conducted carefully. Aspects of designing and conducting a systematic review for network meta-analysis include defining the review question, specifying eligibility criteria, searching for and selecting studies, assessing risk of bias and quality of evidence, conducting a network meta-analysis, interpreting and reporting findings. This commentary summarizes the methodologic challenges and research opportunities for network meta-analysis relevant to each aspect of the systematic review process based on discussions at a network meta-analysis methodology meeting we hosted in May 2010 at the Johns Hopkins Bloomberg School of Public Health. Since this commentary reflects the discussion at that meeting, it is not intended to provide an overview of the field.