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Crossroads of methodological choices in research synthesis: insights from two network meta-analyses on preventing

Giovanni Ostuzzi1, Johannes Schneider-Thoma2, Federico Tedeschi3

  • 1WHO Collaborating Centre for Research and Training in Mental Health and Service Evaluation, Department of Neuroscience, Biomedicine and Movement Sciences, Università degli Studi di Verona, Verona, Italy giovanni.ostuzzi@univr.it.

BMJ Mental Health
|May 17, 2023
PubMed

Insights

Network meta-analyses are crucial for clinical guidelines but lack methodological consensus. Different choices in analyzing schizophrenia relapse prevention impact results and interpretation.

Area of Science:

  • Psychiatry and Mental Health
  • Evidence-Based Medicine
  • Statistical Methodology

Background:

  • Network meta-analysis (NMA) is increasingly used for clinical guidelines and policy decisions.
  • Methodological and statistical aspects of NMA are still evolving, leading to varied approaches.
  • Discrepancies in NMA methodology can arise from different research groups' expertise.

Purpose of the Study:

  • To critically assess two NMAs on pharmacological relapse prevention in schizophrenia.
  • To highlight how differing methodological choices influence analysis outcomes.
  • To examine the clinical-epidemiological interpretation of NMA results.

Main Methods:

  • Comparative analysis of two distinct NMAs on schizophrenia relapse prevention.
  • Focus on methodological and statistical choices made by different research groups.
  • Discussion of key technical issues in NMA, including transitivity assessment.

Main Results:

  • Methodological variations in NMAs can lead to different conclusions regarding treatment efficacy.
  • The choice of statistical methods and assumptions significantly impacts the interpretation of results.
  • Lack of consensus on issues like transitivity assessment complicates direct comparisons.

Conclusions:

  • Standardized methodological guidelines for NMAs are needed for consistent and reliable evidence synthesis.
  • Researchers must carefully consider and report methodological choices in NMAs.
  • Further research is required to address unresolved methodological challenges in NMA.
Keywords:
Schizophrenia & psychotic disorders

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