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Meta-review: network meta-analyses in child and adolescent psychiatry

Meta-review: network meta-analyses in child and adolescent psychiatry
Meta-review: network meta-analyses in child and adolescent psychiatry
Objective
Network meta-analyses (NMAs) are gaining traction as the preferred method for evidence synthesis of intervention studies. This review aimed to summarize the basics of NMAs and conduct a meta-review of available NMAs on the treatment of child and adolescent psychiatric disorders by appraising their quality.

Method
PubMed (Medline), PsycInfo, Embase, Ovid Medline, and Web of Knowledge were systematically searched (last update January 9, 2018). The quality of each included NMA was appraised using the AMSTAR-2 tool and the PRISMA-NMA checklist, which includes specific items for NMAs.

Results
Eighteen NMAs (6 on attention-deficit/hyperactivity disorder; 4 on psychotic disorders; 2 on depression; 2 on anxiety disorders; 1 on obsessive-compulsive disorder; 1 on disruptive behavior disorder, 1 on bipolar disorder, and 1 on antipsychotics across disorders) were retrieved. Results from the AMSTAR-2 assessment showed that only 27% of appraised NMAs were rated as moderate quality; most were rated as low (33%) or critically low (40%) quality. Only 3 of the appraised NMAs reported on all PRISMA-NMA items specific for NMAs; the network structure was graphically presented in most NMAs (80%), and inconsistency was described in only 47%.

Conclusion
Given the paucity of head-to-head trials in child and adolescent psychiatry, NMAs have the potential to contribute to the field, because they provide evidence-based hierarchies for treatment decision making, even in the absence of trials directly comparing at least 2 treatments. However, because of important limitations in the included NMAs, additional methodologically sound NMAs are needed to inform future guidelines and clinical practice in child and adolescent psychiatry.
1527-5418
167-179
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Tomlinson, Anneka
80f29c9c-02ce-4919-b095-32ae5e88bf05
Cipriani, Andrea
39423c02-ca41-4c8e-8ad3-a8332abb88e3
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Tomlinson, Anneka
80f29c9c-02ce-4919-b095-32ae5e88bf05
Cipriani, Andrea
39423c02-ca41-4c8e-8ad3-a8332abb88e3

Cortese, Samuele, Tomlinson, Anneka and Cipriani, Andrea (2019) Meta-review: network meta-analyses in child and adolescent psychiatry. Journal of the American Academy of Child and Adolescent Psychiatry, 58 (2), 167-179. (doi:10.1016/j.jaac.2018.07.891).

Record type: Article

Abstract

Objective
Network meta-analyses (NMAs) are gaining traction as the preferred method for evidence synthesis of intervention studies. This review aimed to summarize the basics of NMAs and conduct a meta-review of available NMAs on the treatment of child and adolescent psychiatric disorders by appraising their quality.

Method
PubMed (Medline), PsycInfo, Embase, Ovid Medline, and Web of Knowledge were systematically searched (last update January 9, 2018). The quality of each included NMA was appraised using the AMSTAR-2 tool and the PRISMA-NMA checklist, which includes specific items for NMAs.

Results
Eighteen NMAs (6 on attention-deficit/hyperactivity disorder; 4 on psychotic disorders; 2 on depression; 2 on anxiety disorders; 1 on obsessive-compulsive disorder; 1 on disruptive behavior disorder, 1 on bipolar disorder, and 1 on antipsychotics across disorders) were retrieved. Results from the AMSTAR-2 assessment showed that only 27% of appraised NMAs were rated as moderate quality; most were rated as low (33%) or critically low (40%) quality. Only 3 of the appraised NMAs reported on all PRISMA-NMA items specific for NMAs; the network structure was graphically presented in most NMAs (80%), and inconsistency was described in only 47%.

Conclusion
Given the paucity of head-to-head trials in child and adolescent psychiatry, NMAs have the potential to contribute to the field, because they provide evidence-based hierarchies for treatment decision making, even in the absence of trials directly comparing at least 2 treatments. However, because of important limitations in the included NMAs, additional methodologically sound NMAs are needed to inform future guidelines and clinical practice in child and adolescent psychiatry.

Other
180625_Cortese_MAIN_TEXT_CLEANED - Accepted Manuscript
Restricted to Repository staff only until 15 November 2019.
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More information

Accepted/In Press date: 15 August 2018
e-pub ahead of print date: 16 October 2018
Published date: February 2019

Identifiers

Local EPrints ID: 424666
URI: https://eprints.soton.ac.uk/id/eprint/424666
ISSN: 1527-5418
PURE UUID: 5fbec1bf-35c5-40f7-a613-d52dbc31b989
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

Catalogue record

Date deposited: 05 Oct 2018 11:40
Last modified: 22 Oct 2019 00:33

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