网络荟萃分析(NMA)同时合成了至少三种治疗方法的相对有效性和安全性的直接和间接证据。决策者可以使用NMA的一致结果来确定哪种治疗对于给定结果是最佳的。然而,这些证据必须在多个结果之间保持平衡.本研究旨在提供一个框架,允许在多个结果中客观整合治疗的比较有效性和安全性。
在提议的框架中,每种治疗表现的测量都绘制在自己的饼图上,叠加在另一个饼图上,代表在所有结果中最好的假设治疗的表现。这将为每个治疗创建一个spie图表,其中覆盖面积代表治疗总体排名最佳的概率。可以调整每个扇区的角度以反映每个结果对决策者的重要性。使用两个已发布的NMA数据集比较膳食油脂和牛皮癣治疗来说明该框架。结果度量是根据累积排名曲线下的表面绘制的。尖顶图的使用与雷达图的使用形成了对比。
在NMA中,比较了膳食油脂对四种脂质生物标志物的影响,使用已发表的冠心病风险预测模型中的系数证明了在尖顶图上纳入脂质相对重要性的容易性.雷达图根据轴上脂质的排序产生了两组区域,而spie图表只制作了一套。在NMA比较牛皮癣治疗中,包含疗效和安全性结果的尖顶图内的区域掩盖了治疗相对安全性的关键信息。将疗效结果的尖顶图内的区域与安全性结果的度量进行绘制,有助于同时比较治疗的益处和危害。
对于整合多种结果的治疗的相对有效性或安全性,尖顶图比雷达图更理想。在决策背景下的正式验证,与其他最近的方法进行统计比较是必需的。
Network meta-analysis (NMA) simultaneously synthesises direct and indirect evidence on the relative efficacy and safety of at least three treatments. A decision maker may use the coherent results of an NMA to determine which treatment is best for a given outcome. However, this evidence must be balanced across multiple outcomes. This
study aims to provide a framework that permits the objective integration of the comparative effectiveness and safety of treatments across multiple outcomes.
In the proposed framework, measures of each treatment\'s performance are plotted on its own pie chart, superimposed on another pie chart representing the performance of a hypothetical treatment that is the best across all outcomes. This creates a spie chart for each treatment, where the coverage area represents the probability a treatment ranks best overall. The angles of each sector may be adjusted to reflect the importance of each outcome to a decision maker. The framework is illustrated using two published NMA datasets comparing dietary oils and fats and psoriasis treatments. Outcome measures are plotted in terms of the surface under the cumulative ranking curve. The use of the spie chart was contrasted with that of the radar plot.
In the NMA comparing the effects of dietary oils and fats on four lipid biomarkers, the ease of incorporating the lipids\' relative importance on spie charts was demonstrated using coefficients from a published risk prediction model on coronary heart disease. Radar plots produced two sets of areas based on the ordering of the lipids on the axes, while the spie chart only produced one set. In the NMA comparing psoriasis treatments, the areas inside spie charts containing both efficacy and safety outcomes masked critical information on the treatments\' comparative safety. Plotting the areas inside spie charts of the efficacy outcomes against measures of the safety outcome facilitated simultaneous comparisons of the treatments\' benefits and harms.
The spie chart is more optimal than a radar plot for integrating the comparative effectiveness or safety of a treatment across multiple outcomes. Formal validation in the decision-making context, along with statistical comparisons with other recent approaches are required.