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Related Experiment Video

Updated: May 15, 2026

The Joint Effect of Social Comparison and Social Distance on Evaluation of Intertemporal Choice Outcomes in Event-related Potential Studies

The Joint Effect of Social Comparison and Social Distance on Evaluation of Intertemporal Choice Outcomes in Event-related Potential Studies

Published on: August 25, 2023

Rank reversal in indirect comparisons.

Edward C Norton¹, Morgen M Miller, Jason J Wang

¹Department of Health Management and Policy, University of Michigan, Ann Arbor, MI 48109, USA. ecnorton@umich.edu

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research

|December 19, 2012

Summary

Rank reversal can cause inconsistent results in indirect treatment comparisons. Choosing the right risk measure based on study design is crucial for accurate meta-analysis rankings.

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Area of Science:

Biostatistics
Clinical Epidemiology
Health Research Methods

Background:

Indirect comparisons in meta-analysis are valuable for evaluating treatments when direct trial data is unavailable.
Rank reversal, where treatment rankings change based on the effect measure used, poses a challenge to consistent interpretation.

Purpose of the Study:

To elucidate rank reversal as a source of inconsistency in indirect treatment comparisons.
To propose best practices for selecting appropriate risk measures in meta-analysis.

Main Methods:

Utilizing intuition, illustrative examples, graphical representations, and mathematical proofs.
Providing supporting software and discussing implications for research and policy.

Main Results:

Different effect measures (risk ratio, risk difference, odds ratio) can yield substantially different treatment rankings in indirect comparisons.
Rank reversal is demonstrated across common statistical measures.

Conclusions:

The selection of a risk measure is critical for accurate indirect treatment comparisons.
The choice of measure should be guided by the specific study design and its underlying conceptual framework.