Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses
Validity of indirect comparison for estimating efficacy of competing interventions: empirical evidence from published meta-analyses
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DOI：
10.1136/bmj.326.7387.472
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发表时间：
2003-03-01
影响因子：
105.7
通讯作者：
Deeks, JJ
中科院分区：
文献类型：
--
作者：
Song, F;Altman, DG;Deeks, JJ
目的利用已发表的随机试验Meta分析数据确定调整后间接比较的有效性，设计直接比较随机试验中不同干预措施的有效性和调整后间接比较两种干预措施的有效性。直接和调整后的间接比较之间的差异通过两个估计值之间的差异来衡量。数据来源有效性综述摘要数据库（1994-8），科克伦系统综述数据库，Medline和检索到的文章的参考文献。在大多数情况下，调整后的间接比较结果与直接比较结果无显著差异。在44次比较中，有3次直接估计值与调整后的间接估计值之间存在显著差异（P < 0.05）。直接比较和调整后的间接比较的统计学结论之间存在中度一致性（kappa 0.51）。两个估计之间的差异的方向是unconsistent.Conclusions调整后的间接比较通常，但并不总是同意头对头随机试验的结果。当随机试验没有直接证据或直接证据不足时，调整后的间接比较可以提供关于竞争性干预措施相对疗效的有用或补充信息。调整后的间接比较的效度取决于所纳入试验的内部效度和相似性。
Objective To determine the validity of adjusted indirect comparisons by using data from published meta-analyses of randomised trials.Design Direct comparison of different interventions in randomised trials and adjusted indirect comparison in which two interventions were compared through their relative effect versus a common comparator. ne discrepancy between the direct and adjusted indirect comparison was measured by the difference between the two estimates.Data sources Database of abstracts of reviews of effectiveness (1994-8), the Cochrane database of systematic reviews, Medline, and references of retrieved articles.Results 44 published meta-analyses (from 28 systematic reviews) provided sufficient data. In most cases, results of adjusted indirect comparisons were not significantly different from those of direct comparisons. A significant discrepancy (P < 0.05) was observed in three of the 44 comparisons between the direct and the adjusted indirect estimates. There was a moderate agreement between the statistical conclusions from the direct and adjusted indirect comparisons (kappa 0.51). The direction of discrepancy between the two estimates was inconsistent.Conclusions Adjusted indirect comparisons usually but not always agree with the results of head to head randomised trials. When there is no or insufficient direct evidence from randomised trials, the adjusted indirect comparison may provide useful or supplementary information on the relative efficacy of competing interventions. The validity of the adjusted indirect comparisons depends on the internal validity and similarity of the included trials.