Use of indirect and mixed treatment comparisons for technology assessment
Use of indirect and mixed treatment comparisons for technology assessment
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DOI：
10.2165/00019053-200826090-00006
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发表时间：
2008-01-01
影响因子：
4.4
通讯作者：
Abrams, Keith
中科院分区：
文献类型：
--
作者：
Sutton, Alex;Ades, A. E.;Abrams, Keith
间接和混合处理比较（MTC）综合方法是更成熟的荟萃分析方法的逻辑延伸。它们具有很大的潜力，可以利用单独不比较所有治疗方案的试验的证据基础来估计多种治疗的相对有效性。连接的证据网络可以同时合成，以提供所有纳入治疗的相对有效性估计，并通过相关的概率陈述对其有效性进行排名。在技术评估中使用间接方法和MTC方法的潜力是相当大的，与简单的替代方法相比，可以进行更一致的评估。虽然这些模型可以被视为标准成对元分析的逻辑和连贯的扩展，但它们增加的复杂性提出了一些独特的问题，这些问题对我们如何在技术评估中使用数据具有深远的影响，同时提出了关于标准成对元分析的搜索问题。本文回顾了配对元分析和间接和MTC方法的综合，清楚地概述了每种方法所涉及的假设。它还提出了国家健康和临床卓越研究所（NICE）在更新其2004年技术评估方法指南时需要考虑的问题，如果这些方法要用于其技术评估。
Indirect and mixed treatment comparison (MTC) approaches to synthesis are logical extensions of more established meta-analysis methods. They have great potential for estimating the comparative effectiveness of multiple treatments using an evidence base of trials that individually do not compare all treatment options. Connected networks of evidence can be synthesized simultaneously to provide estimates of the comparative effectiveness of all included treatments and a ranking of their effectiveness with associated probability statements.The potential of the use of indirect and MTC methods in technology assessment is considerable, and would allow for a more consistent assessment than simpler alternative approaches. Although such models can be viewed as a logical and coherent extension of standard pair-wise meta-analysis, their increased complexity raises some unique issues with far-reaching implications concerning how we use data in technology assessment, while simultaneously raising searching questions about standard pair-wise meta-analysis. This article reviews pair-wise meta-analysis and indirect and MTC approaches to synthesis, clearly outlining the assumptions involved in each approach. It also raises the issues that the National Institute for Health and Clinical Excellence (NICE) needed to consider in updating their 2004 Guide to the Methods of Technology Appraisal, if such methods are to be used in their technology appraisals.