论文标题

连接和断开网络中组件网络荟萃分析的模型选择:仿真研究

Model selection for component network meta-analysis in connected and disconnected networks: a simulation study

论文作者

Petropoulou, Maria, Rücker, Gerta, Weibel, Stephanie, Kranke, Peter, Schwarzer, Guido

论文摘要

网络荟萃分析(NMA)广泛用于证据合成,以估算给定临床状况的几种竞争干预措施的影响。挑战之一是在断开网络中不可能。组件网络荟萃分析(CNMA)允许技术“重新连接”具有多组分干预措施的断开网络。加性CNMA模型假定任何多组分干预的效果是其成分的加性和。可以通过添加相互作用组件项来放松此假设,从而提高拟合的优点,但会降低网络连接性。模型选择旨在在拟合优度和连接性(选定的CNMA模型)之间找到合理平衡的模型。我们旨在为CNMA模型引入远期模型选择策略,并研究连接和断开网络的CNMA模型的性能。我们将这些方法应用于真正的Cochrane审查数据集,并具有添加性,轻度或强烈违反干预效果的模拟数据。我们从连接的网络开始,然后人工构建了断开的网络。我们使用平均误差和覆盖率概率比较了每个连接和断开网络的添加剂和所选的CNMA的结果。 CNMA模型可为连接的网络提供良好的性能,如果成立性保持,则可以替代标准NMA。相反,模型选择对于断开网络的性能不佳,我们建议对子网进行单独的分析。

Network meta-analysis (NMA) is widely used in evidence synthesis to estimate the effects of several competing interventions for a given clinical condition. One of the challenges is that it is not possible in disconnected networks. Component network meta-analysis (CNMA) allows technically 'reconnecting' a disconnected network with multicomponent interventions. The additive CNMA model assumes that the effect of any multicomponent intervention is the additive sum of its components. This assumption can be relaxed by adding interaction component terms, which improves the goodness of fit but decreases the network connectivity. Model selection aims at finding the model with a reasonable balance between the goodness of fit and connectivity (selected CNMA model). We aim to introduce a forward model selection strategy for CNMA models and to investigate the performance of CNMA models for connected and disconnected networks. We applied the methods to a real Cochrane review dataset and simulated data with additive, mildly, or strongly violated intervention effects. We started with connected networks, and we artificially constructed disconnected networks. We compared the results of the additive and the selected CNMAs from each connected and disconnected network with the NMA using the mean squared error and coverage probability. CNMA models provide good performance for connected networks and can be an alternative to standard NMA if additivity holds. On the contrary, model selection does not perform well for disconnected networks, and we recommend conducting separate analyses of subnetworks.

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