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Response to discussant comments on "NMA, the first 20 years".
A E Ades1, Nicky J Welton1, Sofia Dias2
1Population Health Sciences, Bristol Medical School, Bristol, UK.
Research Synthesis Methods
|July 26, 2024
Summary
Network meta-analysis (NMA) continues to evolve, facing ongoing controversies. This response addresses methodological guidance, the estimand framework, and data availability for reimbursement and guideline development.
Area of Science:
- Health research methodology
- Evidence synthesis
- Biostatistics
Background:
- Network meta-analysis (NMA) has been utilized for two decades, yet methodological controversies persist.
- Recent developments in NMA require re-evaluation of existing practices and guidance.
- The integration of advanced frameworks like the estimand framework is crucial for robust evidence synthesis.
Purpose of the Study:
- To respond to discussant comments on "Twenty years of network meta-analysis: Continuing controversies and recent developments."
- To explore the generation of methodological guidance in evidence synthesis.
- To examine the integration of the estimand framework with NMA and its implications for decision-making.
Main Methods:
- Discussion and critical analysis of current network meta-analysis practices.
- Exploration of the estimand framework's application in evidence synthesis.
- Consideration of the European Joint Clinical Assessment process and its impact.
Main Results:
- Methodological guidance generation requires careful consideration of transparency and consistency.
- The estimand framework offers a structured approach to defining synthesis objectives.
- Lack of routine access to individual patient data hinders reimbursement and guideline development.
Conclusions:
- Transparent and consistent decision-making necessitates specific properties for population adjustment methods.
- Increased availability of individual patient data is vital for healthcare authorities and guideline developers.
- Continued dialogue and development are essential for advancing network meta-analysis.
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