Importance of assessing and adjusting for cross-study heterogeneity in network meta-analysis: a case study of psoriasis - PubMed (original) (raw)

. 2018 Nov;7(11):1037-1051.

doi: 10.2217/cer-2018-0065. Epub 2018 Oct 2.

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• PMID: 30277080
• DOI: 10.2217/cer-2018-0065

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Importance of assessing and adjusting for cross-study heterogeneity in network meta-analysis: a case study of psoriasis

Chris Cameron et al. J Comp Eff Res. 2018 Nov.

Free article

Abstract

Aim: The importance of adjusting for cross-study heterogeneity when conducting network meta-analyses (NMAs) was demonstrated using a case study of biologic therapies for moderate-to-severe plaque psoriasis.

Methods: Bayesian NMAs were conducted for Psoriasis Area and Severity Index 90 response. Several covariates were considered to account for cross-trial differences: baseline risk (i.e., placebo response), prior biologic use, body weight, psoriasis duration, age, race and baseline Psoriasis Area and Severity Index score. Model fit was evaluated.

Results: The baseline risk-adjusted NMA, which adjusts for multiple observed and unobserved effect modifiers, was associated with the best model fit. Lack of adjustment for cross-trial differences led to different clinical interpretations of findings.

Conclusion: Failure to adjust for cross-trial differences in NMA can have important implications for clinical interpretations when studying the comparative efficacy of healthcare interventions.

Keywords: Psoriasis Area and Severity Index; biologic; heterogeneity; indirect comparison; network meta-analysis; placebo response; psoriasis.

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