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A multifaceted graphical display, including treatment ranking, was developed to aid interpretation of network meta-analysis

  • Clareece R Nevill
    Correspondence
    Correspondence to: Clareece R Nevill Biostatistics Research Group, Department of Health Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, (+44)7840 012456
    Affiliations
    Department of Population Health Sciences, University of Leicester, UK

    NIHR Complex Reviews Support Unit, University of Leicester & University of Glasgow, Glasgow, UK
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  • Nicola J Cooper
    Affiliations
    Department of Population Health Sciences, University of Leicester, UK

    NIHR Complex Reviews Support Unit, University of Leicester & University of Glasgow, Glasgow, UK
    Search for articles by this author
  • Alex J Sutton
    Affiliations
    Department of Population Health Sciences, University of Leicester, UK

    NIHR Complex Reviews Support Unit, University of Leicester & University of Glasgow, Glasgow, UK
    Search for articles by this author
Open AccessPublished:March 02, 2023DOI:https://doi.org/10.1016/j.jclinepi.2023.02.016
A multifaceted graphical display, including treatment ranking, was developed to aid interpretation of network meta-analysis
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      HIGHLIGHTS

      • •
        The ability to conduct a network meta-analysis (NMA) and thus rank included interventions is a powerful tool; however, the presentation of rankings in particular can easily be misinterpreted.
      • •
        Two new ranking visualisations have been developed – the Litmus Rank-O-Gram and the Radial SUCRA plot – to improve the presentation of ranking results.
      • •
        The new visualisations have been embedded within a novel multi-panel display, alongside presentation of evidence networks and relative effect estimates, programmed within MetaInsight, an interactive web-based app for NMA, with user feedback gained.
      • •
        The multi-panel display provides an all-encompassing graphic to encourage a holistic understanding of the NMA, in turn, improving the interpretation and dissemination of NMAs for clinicians and decision-makers.

      Abstract

      Objective

      Network meta-analysis (NMA) is becoming a popular statistical tool for analysing a network of evidence comparing more than two interventions. A particular advantage of NMA over pairwise meta-analysis is its ability to simultaneously compare multiple interventions including comparisons not previously trialled together, permitting intervention hierarchies to be created. Our aim was to develop a novel graphical display to aid interpretation of NMA to clinicians and decision-makers that incorporates ranking of interventions.

      Study Design and Setting

      Current literature was searched, scrutinised, and provided direction for developing the novel graphical display. Ranking results were often found to be misinterpreted when presented alone and, to aid interpretation and effective communication to inform optimal decision-making, need to be displayed alongside other important aspects of the analysis including the evidence networks and relative intervention effect estimates.

      Results

      Two new ranking visualisations were developed – the Litmus Rank-O-Gram, and the Radial SUCRA plot – and embedded within a novel multi-panel graphical display programmed within the MetaInsight app, with user feedback gained.

      Conclusion

      This display was designed to improve the reporting, and facilitate a holistic understanding, of NMA results. We believe uptake of the display would lead to better understanding of complex results and improve future decision-making.

      Keywords

      Article info

      Publication history

      Accepted: February 2, 2023
      Received in revised form: December 21, 2022
      Received: May 27, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Author Details

      Biostatistics Research Group, Department of Population Health Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK, Clareece R Nevill Research Associate [email protected]

      Biostatistics Research Group, Department of Population Health Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK, Nicola J Cooper Professor [email protected]

      Biostatistics Research Group, Department of Population Health Sciences, George Davies Centre, University of Leicester, University Road, Leicester, LE1 7RH, UK, Alex J Sutton Professor [email protected]

      Author Contributions

      Clareece R Nevill Data Curation, Formal Analysis, Investigation, Methodology, Visualization, Software, Writing – Original Draft, Writing – Review & Editing

      Nicola J Cooper Conceptualization, Methodology, Visualization, Writing – Review & Editing

      Alex J SuttonConceptualization, Methodology, Visualization, Writing – Review & Editing.

      Declaration of interests

      The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

      The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:

      Identification

      DOI: https://doi.org/10.1016/j.jclinepi.2023.02.016

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      © 2023 The Author(s). Published by Elsevier Inc.

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