Network meta-analysis incorporating randomized controlled trials and non-randomized comparative cohort studies for assessing the safety and effectiveness of medical treatments: challenges and opportunities

We describe network meta-analysis involving both randomized controlled trials and non-randomized comparative cohort studies—defined as cohort studies that compare two or more treatment alternatives using observational data

Chris Cameron

2015

Scholarcy highlights

  • Many medical conditions exist for which there are multiple treatment options
  • We describe network meta-analysis involving both randomized controlled trials and non-randomized comparative cohort studies—defined as cohort studies that compare two or more treatment alternatives using observational data
  • In other situations, the findings reported in the non-randomized studies do not align with those reported in RCTs
  • The interest in and need for incorporating both RCTs and non-randomized studies in NMA will likely increase in the future due to the growing need to assess multiple treatments simultaneously, improvement in the quality and validity of non-randomized data and analytic methods, and the global movement towards progressive licensing and product listing agreements where information on a medical product is monitored throughout its life cycle for regulatory and reimbursement purposes
  • The inclusion of low-quality, non-randomized studies with inadequate control for biases may threaten the validity of the NMA findings
  • More studies are needed to compare the validity of different approaches that combine RCTs and non-randomized studies in NMA
  • The inclusion of both types of data in network meta-analysis poses several methodological challenges, it offer promises to provide more timely, comprehensive, and generalizable evidence on the comparative safety and effectiveness of medical treatments

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