NICE DSU Technical Support Document 2: A Generalised Linear Modelling Framework for Pairwise and Network Meta-Analysis of Randomised Controlled Trials

Sofia Dias · Nicky J. Welton · Alex J. Sutton · Anthony E. Ades

555 citations0/0 files storedBristol Research (University of Bristol)

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Meta-analysis and systematic reviews Statistical Methods in Clinical Trials Statistical Methods and Bayesian Inference

Abstract

This paper sets out a generalised linear model (GLM) framework for the synthesis of data from randomised controlled trials (RCTs). We describe a common model taking the form of a linear regression for both fixed and random effects synthesis, that can be implemented with Normal, Binomial, Poisson, and Multinomial data. The familiar logistic model for meta- analysis with Binomial data is a GLM with a logit link function, which is appropriate for probability outcomes. The same linear regression framework can be applied to continuous outcomes, rate models, competing risks, or ordered category outcomes, by using other link functions, such as identity, log, complementary log-log, and probit link functions. The common core model for the linear predictor can be applied to pair-wise meta-analysis, indirect comparisons, synthesis of multi-arm trials, and mixed treatment comparisons, also known as network meta-analysis, without distinction.We take a Bayesian approach to estimation and provide WinBUGS program code for a Bayesian analysis using Markov chain Monte Carlo (MCMC) simulation. An advantage of this approach is that it is straightforward to extend to shared parameter models where different RCTs report outcomes in different formats but from a common underlying model. Use of the GLM framework allows us to present a unified account of how models can be compared using the Deviance Information Criterion (DIC), and how goodness of fit can be assessed using the residual deviance. WinBUGS code for model critique is provided. Our approach is illustrated through a range of worked examples for the commonly encountered evidence formats, including shared parameter models.We give suggestions on computational issues that sometimes arise in MCMC evidence synthesis, and comment briefly on alternative software.

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References

1986Meta-analysis in clinical trials 2010Conducting Meta-Analyses in R with the metafor Package 1988Statistical Methods for Meta-Analysis 1995The Handbook of Research Synthesis.2000Systematic Reviews in Health Care : Meta-Analysis in Context 2004Combination of direct and indirect evidence in mixed treatment comparisons 1997The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials 2004What to add to nothing? Use and avoidance of continuity corrections in meta‐analysis of sparse data

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