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dc.contributor.authorHawkins, Neil
dc.contributor.authorScott, David A
dc.contributor.authorWoods, Beth S
dc.contributor.authorThatcher, Nick
dc.date.accessioned2010-08-09T14:49:44Z
dc.date.available2010-08-09T14:49:44Z
dc.date.issued2009-09
dc.identifier.citationNo study left behind: a network meta-analysis in non-small-cell lung cancer demonstrating the importance of considering all relevant data. 2009, 12 (6):996-1003 Value Healthen
dc.identifier.issn1524-4733
dc.identifier.pmid19402854
dc.identifier.doi10.1111/j.1524-4733.2009.00541.x
dc.identifier.urihttp://hdl.handle.net/10541/109324
dc.description.abstractOBJECTIVE: To demonstrate the importance of considering all relevant indirect data in a network meta-analysis of treatments for non-small-cell lung cancer (NSCLC). METHODS: A recent National Institute for Health and Clinical Excellence appraisal focussed on the indirect comparison of docetaxel with erlotinib in second-line treatment of NSCLC based on trials including a common comparator. We compared the results of this analysis to a network meta-analysis including other trials that formed a network of evidence. We also examined the importance of allowing for the correlations between the estimated treatment effects that can arise when analysing such networks. RESULTS: The analysis of the restricted network including only trials of docetaxel and erlotinib linked via the common placebo comparator produced an estimated mean hazard ratio (HR) for erlotinib compared with docetaxel of 1.55 (95% confidence interval [CI] 0.72-2.97). In contrast, the network meta-analysis produced an estimated HR for erlotinib compared with docetaxel of 0.83 (95% CI 0.65-1.06). Analyzing the wider network improved the precision of estimated treatment effects, altered their rankings and also allowed further treatments to be compared. Some of the estimated treatment effects from the wider network were highly correlated. CONCLUSIONS: This empirical example shows the importance of considering all potentially relevant data when comparing treatments. Care should therefore be taken to consider all relevant information, including correlations induced by the network of trial data, when comparing treatments.
dc.language.isoenen
dc.subjectAnticancerous Agentsen
dc.subjectLung Canceren
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshAntineoplastic Agents
dc.subject.meshBias (Epidemiology)
dc.subject.meshCarcinoma, Non-Small-Cell Lung
dc.subject.meshData Interpretation, Statistical
dc.subject.meshFemale
dc.subject.meshHumans
dc.subject.meshLung Neoplasms
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshProportional Hazards Models
dc.subject.meshProtein Kinase Inhibitors
dc.subject.meshQuinazolines
dc.subject.meshRandomized Controlled Trials as Topic
dc.subject.meshResearch Design
dc.subject.meshTaxoids
dc.subject.meshYoung Adult
dc.titleNo study left behind: a network meta-analysis in non-small-cell lung cancer demonstrating the importance of considering all relevant data.en
dc.typeArticleen
dc.contributor.departmentOxford Outcomes Ltd., Oxford, UK. neil.hawkins@oxfordoutcomes.comen
dc.identifier.journalValue in Healthen
html.description.abstractOBJECTIVE: To demonstrate the importance of considering all relevant indirect data in a network meta-analysis of treatments for non-small-cell lung cancer (NSCLC). METHODS: A recent National Institute for Health and Clinical Excellence appraisal focussed on the indirect comparison of docetaxel with erlotinib in second-line treatment of NSCLC based on trials including a common comparator. We compared the results of this analysis to a network meta-analysis including other trials that formed a network of evidence. We also examined the importance of allowing for the correlations between the estimated treatment effects that can arise when analysing such networks. RESULTS: The analysis of the restricted network including only trials of docetaxel and erlotinib linked via the common placebo comparator produced an estimated mean hazard ratio (HR) for erlotinib compared with docetaxel of 1.55 (95% confidence interval [CI] 0.72-2.97). In contrast, the network meta-analysis produced an estimated HR for erlotinib compared with docetaxel of 0.83 (95% CI 0.65-1.06). Analyzing the wider network improved the precision of estimated treatment effects, altered their rankings and also allowed further treatments to be compared. Some of the estimated treatment effects from the wider network were highly correlated. CONCLUSIONS: This empirical example shows the importance of considering all potentially relevant data when comparing treatments. Care should therefore be taken to consider all relevant information, including correlations induced by the network of trial data, when comparing treatments.


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