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Indirect treatment comparisons and mixed treatment comparisons

Indirect treatment comparisons and mixed treatment comparisons (network meta-analyses) are new statistical tools for comparing research studies when there is no direct evidence, insufficient direct evidence or more than two interventions need to be compared.

Indirect treatment comparison (ITC) and mixed treatment comparison (MTC) methods are developing fast. These methods are already widely used in health care to understand better the comparative effectiveness of different treatments, devices and diagnostic techniques.

Undertaking these analyses requires specialist knowledge. York Health Economics Consortium (leaders in the field of health economics, economic modelling and systematic reviews) and Quantics (leaders in the field of life science statistics) have successfully delivered many ITC and MTC analyses and can provide solutions to your ITC, systematic review, modelling and statistical needs.

We offer a range of services to inform the development and conduct of an ITC or MTC. We can provide a complete package from systematic review through to the ITC/MTC analysis, or any of the individual stages of the process.

Scoping the question to be answered

We can help you to refine and define your research question to help produce a project protocol which will achieve your objectives. We can scope the size of the literature and review current practice, to identify the interventions which might feature in the network.

Identifying relevant studies

We can undertake literature searches to ensure all relevant studies are identified. This may involve a systematic review or a confirmatory literature search, depending on your needs.

Assessing the similarity of studies to feature in a network

Assessing study similarity is important for robust networks, and involves assessing study methods, the population, the interventions and the outcomes for similarity. Following similarity assessment studies may be excluded from a network.

Conducting an early network meta-analysis

An early network meta-analysis, identifying and assessing the similarity of trials, can help inform clinical trial design, with a view to conducting clinical trials which may be able to feature in a future NMA.

Conducting ITCs and MTCs using statistical modelling approaches (including Bayesian approaches in WinBUGS)

There are several methods for preparing ITCs and MTCs and we can advise on the best methods for the question and studies being addressed. We are experienced in producing NMAs using WinBUGS.

Applying advanced ITC and MTC techniques where required

Where studies do not easily fit into a network, we can investigate advanced techniques to provide data to contribute to a network. Advanced techniques might include meta-regression or the incorporation of individual patient data (IPD). We can also explore options for taking data from studies to create similar studies for assessment

Providing full methods documentation

All our analyses are fully documented. Code and data are provided, as well as a full description of the methods and results of the analyses.

Writing publications

We are always keen to publish and can write manuscripts for publication, conference abstracts and Powerpoint presentations.

Critiquing/independent review of published or draft ITCs/MTCs

We can undertake an independent  review of the literature, statistical validity and conclusions of already published NMAs. This can provide insights into the methods and findings of published ITCs/MTCs. We can also peer review draft ITCs/MTCs to help to ensure that no major errors have been made prior to publication.

Indirect treatment comparisons


Mixed treatment comparisons


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