No study left behind: a network meta-analysis in non-small-cell lung cancer demonstrating the importance of considering all relevant data
No study left behind: a network meta-analysis in non-small-cell lung cancer demonstrating the importance of considering all relevant data
OBJECTIVE: 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.
Adult, Aged, Aged, 80 and over, Antineoplastic Agents/therapeutic use, Bias, Carcinoma, Non-Small-Cell Lung/drug therapy, Data Interpretation, Statistical, Docetaxel, Erlotinib Hydrochloride, Female, Humans, Lung Neoplasms/drug therapy, Male, Middle Aged, Proportional Hazards Models, Protein Kinase Inhibitors/therapeutic use, Quinazolines/therapeutic use, Randomized Controlled Trials as Topic, Research Design, Taxoids/therapeutic use, Young Adult
996-1003
Hawkins, Neil
1aa8112d-606d-4176-b306-9c22158c556d
Scott, David A
19b5fd34-9974-4ae4-8be0-27a693639e20
Woods, Beth S
13ca1259-13b5-45c6-b837-b59e95dd1454
Thatcher, Nicholas
8d83757f-e099-410e-9290-4917cbd7cd35
September 2009
Hawkins, Neil
1aa8112d-606d-4176-b306-9c22158c556d
Scott, David A
19b5fd34-9974-4ae4-8be0-27a693639e20
Woods, Beth S
13ca1259-13b5-45c6-b837-b59e95dd1454
Thatcher, Nicholas
8d83757f-e099-410e-9290-4917cbd7cd35
Hawkins, Neil, Scott, David A, Woods, Beth S and Thatcher, Nicholas
(2009)
No study left behind: a network meta-analysis in non-small-cell lung cancer demonstrating the importance of considering all relevant data.
Value in Health, 12 (6), .
(doi:10.1111/j.1524-4733.2009.00541.x).
Abstract
OBJECTIVE: 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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Published date: September 2009
Keywords:
Adult, Aged, Aged, 80 and over, Antineoplastic Agents/therapeutic use, Bias, Carcinoma, Non-Small-Cell Lung/drug therapy, Data Interpretation, Statistical, Docetaxel, Erlotinib Hydrochloride, Female, Humans, Lung Neoplasms/drug therapy, Male, Middle Aged, Proportional Hazards Models, Protein Kinase Inhibitors/therapeutic use, Quinazolines/therapeutic use, Randomized Controlled Trials as Topic, Research Design, Taxoids/therapeutic use, Young Adult
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Local EPrints ID: 441393
URI: http://eprints.soton.ac.uk/id/eprint/441393
ISSN: 1098-3015
PURE UUID: 649d0847-9f1e-4c77-946a-2414b9c06994
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Date deposited: 11 Jun 2020 16:30
Last modified: 17 Mar 2024 04:02
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Author:
Neil Hawkins
Author:
David A Scott
Author:
Beth S Woods
Author:
Nicholas Thatcher
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