The online version of this article (doi:10.1186/1471-2288-14-105) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
PS developed and implemented the novel synthesis models, conducted the analysis and prepared the final manuscript. L-HC structured the evidence base and conducted preliminary data analysis using existing published synthesis methodology. MS oversaw and advised on all elements of the work undertaken and prepared the final manuscript. All authors read and approved the final manuscript.
Network meta-analysis methods extend the standard pair-wise framework to allow simultaneous comparison of multiple interventions in a single statistical model. Despite published work on network meta-analysis mainly focussing on the synthesis of aggregate data, methods have been developed that allow the use of individual patient-level data specifically when outcomes are dichotomous or continuous. This paper focuses on the synthesis of individual patient-level and summary time to event data, motivated by a real data example looking at the effectiveness of high compression treatments on the healing of venous leg ulcers.
This paper introduces a novel network meta-analysis modelling approach that allows individual patient-level (time to event with censoring) and summary-level data (event count for a given follow-up time) to be synthesised jointly by assuming an underlying, common, distribution of time to healing. Alternative model assumptions were tested within the motivating example. Model fit and adequacy measures were used to compare and select models.
Due to the availability of individual patient-level data in our example we were able to use a Weibull distribution to describe time to healing; otherwise, we would have been limited to specifying a uniparametric distribution. Absolute effectiveness estimates were more sensitive than relative effectiveness estimates to a range of alternative specifications for the model.
The synthesis of time to event data considering individual patient-level data provides modelling flexibility, and can be particularly important when absolute effectiveness estimates, and not just relative effect estimates, are of interest.
Saramago P, Sutton AJ, Cooper NJ, Manca A: Mixed treatment comparisons using aggregate- and individual-participant level data. Stat Med. 2012, 10; 31 (28): 3516-3536. CrossRef
Jansen J, Cope S: Network meta-analysis of individual and aggregate level data. Value Health. 2012, 15 (4): A159- CrossRef
Sutton AJ: Methods for Meta-Analysis in Medical Research. 2000, Chichester ; New York: J. Wiley
Welton NJ, Willis SR, Ades AE: Synthesis of survival and disease progression outcomes for health technology assessment of cancer therapies. Res Synth Method. 2010, 1: 239-257. doi: 10.1002/jrsm.21 CrossRef
Soares MO, Dumville JC, Ades AE, Welton NJ: Treatment comparisons for decision making: facing the problems of sparse and few data. J R Stat Soc A Stat Soc. 2014, 177: 259-279. doi: 10.1111/rssa.12010 CrossRef
Ashby RL, Gabe R, Ali S, Saramago P, Chuang LH, Adderley U, Bland JM, Cullum NA, Dumville JC, Iglesias CP, Soares MO, Stubbs NC, Torgerson DJ: VenUS IV (venous leg ulcer study IV): a randomised controlled trial of compression hosiery versus compression bandaging in the treatment of venous leg ulcers. Health Technology Assessment (forthcoming). 2014
Duby T, Hoffman D, Cameron J, Doblhoffbrown D, Cherry G, Ryan T: A randomized trial in the treatment of venous Leg ulcers comparing short stretch bandages, 4 layer bandage system, and a long stretch paste bandage system. Wounds-a Compendium Clin Res Pract. 1993, 5 (6): 276-279.
Junger M, Wollina U, Kohnen R, Rabe E: Efficacy and tolerability of an ulcer compression stocking for therapy of chronic venous ulcer compared with a below-knee compression bandage: results from a prospective, randomized, multicentre trial. Curr Med Res Opin. 2004, 20 (10): 1613-1623. CrossRefPubMed
Kralj B, Kosicek M: Randomised Comparative Trial of Single-Layer and Multi-Layer Bandages in the Treatment of Venous leg Ulcer. 1995, Harrogate, UK: 6th European Conference on Advances in Wound Management: 1995, 158-160.
Wilkinson E, Buttfield S, Cooper S, Young E: Trial of two bandaging systems for chronic venous leg ulcers. J Wound Care. 1997, 6 (7): 339-340. PubMed
Colgan MP, Teevan M, McBride C, O’Sullivan L, Moore D, Shanik G: Cost Comparisons in the Management of Venous Ulceration. 1995, Harrogate, UK: 5th European Conference on Advances in Wound Management: 21–24 November 1995
Moffatt C, Edwards L, Collier M, Treadwell T, Miller M, Shafer L, Sibbald G, Brassard A, McIntosh A, Reyzelman A, Price P, Kraus SM, Walters SA, Harding K: A randomised controlled 8-week crossover clinical evaluation of the 3M coban 2 layer compression system versus profore to evaluate the product performance in patients with venous leg ulcers. Int Wound J. 2008, 5 (2): 267-279. CrossRefPubMed
Wong I, Andriessen A, Charles H, Thompson D, Lee D, So W, Abel M: Randomized controlled trial comparing treatment outcome of two compression bandaging systems and standard care without compression in patients with venous leg ulcers. J Eur Acad Dermatol Venereol. 2012, 26 (1): 102-110. CrossRefPubMed
Iglesias C, Nelson E, Cullum N, Torgerson D: VenUS I: a randomised controlled trial of two types of bandage for treating venous leg ulcers. Health Technol Assess. 2004, 8 (29): iii, 1-iii, 105. CrossRef
Collett D: Modelling Survival Data in Medical Research. 2003, Boca Raton, Fla: Chapman & Hall/CRC, 2
Lunn DJ, Thomas A, Best N, Spiegelhalter D: WinBUGS - a Bayesian modelling framework: concepts, structure, and extensibility. Statistics and Computing. 2000, 10 (4): 325-337. CrossRef
Spiegelhalter DJ, Best NG, Carlin BR, van der Linde A: Bayesian measures of model complexity and fit. J R Stat Soc B Stat Soc. 2002, 64: 583-616. CrossRef
StataCorp A: Stata Statistical Software: Release 12. 2011, College Station, TX: StataCorp LP
Akaike H: Information Theory and the Maximum Likelihood Principle. 1973, 2nd International Symposium in Information Theory: 1973, 267-281.
O’Meara S, Tierney J, Cullum N, Bland J, Franks P, Mole T, Scriven M: Four layer bandage compared with short stretch bandage for venous leg ulcers: systematic review and meta-analysis of randomised controlled trials with data from individual patients. BMJ (Clinical research ed). 2009, 338 (7702): 1054-1057.
Espinoza M: Heterogeneity in cost-effectiveness analysis: methods to explore the value of subgroups and individualised care in a collectively funded health system. 2012, University of York
Medical Research Council Data Sharing. http://www.mrc.ac.uk/research/research-policy-ethics/data-sharing/ (accessed in September 2014)
National Institute for Health Research - Health Technology Assessment Data Sharing. http://www.journalslibrary.nihr.ac.uk/information-for-authors/data-sharing (accessed in September 2014)
- Network meta-analysis of (individual patient) time to event data alongside (aggregate) count data
Marta O Soares
- BioMed Central
Neu im Fachgebiet AINS
Meistgelesene Bücher aus dem Fachgebiet AINS
Mail Icon II