Network Meta-analysis of Antidepressants: A Bridge Too Far?

Volume 5 # 1 January 2019   Alan Eppel MB, FRCPC McMaster University   ABSTRACT   Network Meta-analysis (NMA) is a powerful ¬†statistical tool that expands the methods of ¬†pairwise Meta-analysis. In this overview NMA is explained for non-statisticians to allow physicians and other clinicians to critically appraise published NMAs. This requires understanding the underlying assumptions of NMA: indirect comparisons, transitivity, consistency, and effect modifiers. The recent NMA of 21 antidepressants (Cipriani et al, 2018) is discussed. Disclosures of conflicts of interest: None Address correspondence or comments to [email protected] and @PsychiatReform on Twitter. Acknowledgements. The author acknowledges with appreciation the assistance of Professor David Streiner McMaster University.     What is Network¬† Meta-analysis? Network meta-analysis (NMA) is a powerful statistical tool that expands the methods of pairwise meta-analysis (MA). Conventional MA is based on the synthesis of data from randomized controlled trials consisting of direct comparisons of two drugs or between a drug and placebo. MA is limited to these pairwise comparisons that have been directly compared in head-to-head trials. NMA is a further development of the methodologies used in MA. NMA is designed to make comparisons of multiple treatments simultaneously. The main theoretical addition that underlies NMA is the … Continue reading Network Meta-analysis of Antidepressants: A Bridge Too Far?