Assessing the impact of a matching-adjusted indirect comparison in a Bayesian network meta-analysis
Assessing the impact of a matching-adjusted indirect comparison in a Bayesian network meta-analysis
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DOI：
10.1002/jrsm.1372
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发表时间：
2019-10-14
影响因子：
9.8
通讯作者：
Walsh, Cathal
中科院分区：
文献类型：
--
作者：
Leahy, Joy;Walsh, Cathal
如果IPD可用于网络荟萃分析（NMA）中的部分或所有试验，则通常认为将该IPD合并到NMA中更可取。然而，通常会出现这样的情况，即研究人员对涉及特定治疗（例如，来自申办者）的试验有IPD，但对其他试验没有IPD。因此，可以使用匹配调整的间接比较（MAIC）对IPD进行重新加权，使IPD试验中的协变量特征与汇总数据（AgD）试验的协变量特征相匹配。我们评估的影响，使用重新加权的汇总数据，获得的MAIC，在贝叶斯NMA的连接治疗网络。我们将这种方法应用于新诊断患者（ndMM）的多发性骨髓瘤治疗网络，其结果是无进展生存期。我们调查的方法和结果的可靠性，通过模拟研究。ndMM网络包括3项比较来那度胺与安慰剂（Len-Placebo）的IPD研究、1项比较Len-Placebo的AgD研究和1项比较沙利度胺与安慰剂（Thal-Placebo）的AgD研究。因此，我们研究了协变量加权的两种选择：（a）所有三项研究均单独加权，以匹配AgD Thal-安慰剂试验。(b)在所有三项IPD研究中对患者进行加权，以匹配AgD Thal-安慰剂试验，但NMA单独考虑每项试验。我们观察到MAIC在整个网络人群中的受益有限。虽然MAIC可以作为敏感性分析来确认患者人群的结果，但我们建议谨慎使用和解释MAIC。
If IPD is available for some or all trials in a network meta-analysis (NMA), then incorporating this IPD into an NMA is routinely considered to be preferable. However, the situation often arises where a researcher has IPD for trials concerning a particular treatment (eg, from a sponsor) but none for other trials. Therefore, one can reweight the IPD so that the covariate characteristics in the IPD trials match that of the aggregate data (AgD) trials, using a matching-adjusted indirect comparison (MAIC). We assess the impact of using the reweighted aggregated data, obtained by the MAIC, in a Bayesian NMA for a connected treatment network. We apply this method to a network of multiple myeloma treatments in newly diagnosed patients (ndMM), where the outcome is progression free survival. We investigate the reliability of the methods and results through a simulation study. The ndMM network consists of three IPD studies comparing lenalidomide to placebo (Len-Placebo), one AgD study comparing Len-Placebo, and one AgD study comparing thalidomide to placebo (Thal-Placebo). We therefore investigate two options of weighting the covariates: (a) All three studies are weighted separately to match the AgD Thal-Placebo trial. (b) Patients are weighted across all three IPD studies to match the AgD Thal-Placebo trial, but the NMA considers each trial separately. We observe limited benefit to MAIC in the full network population. While MAIC can be beneficial as a sensitivity analysis to confirm results across patient populations, we advise that MAIC is used and interpreted with caution.