Comparison of Bayesian Network Meta-Analyses in a Winbugs and SAS Framework

IntroductionOsteoarthritis is a common degenerative joint disease that eventually leads to disability and poor quality of life. The main symptoms are joint pain and mobility disorders. If the patient has severe pain or other analgesics are contraindicated, opioids may be a viable treatment option. To evaluate and compare the efficacy and safety of opioids in the treatment of knee or hip osteoarthritis, we will integrate direct and indirect evidence using a Bayesian network meta-analysis to establish hierarchies of these drugs.Methods and analysisWe will search the Medical Literature Analysis and Retrieval System Online, Excerpta Medica database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Web of Science and PsycINFO databases as well as published and unpublished research in international registries and regulatory agency websites for osteoarthritis reports published prior to 5 January 2018. There will be no restrictions on the language. Randomised clinical trials that compare oral or transdermal opioids with other various opioids, placebo or no treatment for patients with knee or hip osteoarthritis will be included. The primary outcomes of efficacy will be pain and function. We will use pain and function scales to evaluate the main outcomes. The secondary outcomes of safety will be defined as the proportion of patients who have stopped treatment due to side effects. Pairwise meta-analyses and Bayesian network meta-analyses will be performed for all related outcome measures. We will conduct subgroup analyses and sensitivity analyses to assess the robustness of our findings. The Grading of Recommendations, Assessment, Development and Evaluations framework will be used to assess the quality of the evidence contributing to each network assessment.Ethics and disseminationThis study does not require formal ethical approval because individual patient data will not be included. The findings will be disseminated through peer-reviewed publications or conference presentations.PROSPERO registration numberCRD42018085503.

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The impact of covariance priors on arm‐based Bayesian network meta‐analyses with binary outcomes

Statistics in Medicine ◽

10.1002/sim.8580 ◽

2020 ◽

Vol 39 (22) ◽

pp. 2883-2900 ◽

Cited By ~ 2

Author(s):

Zhenxun Wang ◽

Lifeng Lin ◽

James S. Hodges ◽

Haitao Chu

Keyword(s):

Bayesian Network ◽

Binary Outcomes ◽

Meta Analyses ◽

The Impact

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PCN292 BAYESIAN NETWORK META-ANALYSES OF OVERALL SURVIVAL: APPLICATION OF DIFFERENT PARAMETRIC AND FRACTIONAL POLYNOMIAL METHODS

Value in Health ◽

10.1016/j.jval.2020.04.1756 ◽

2020 ◽

Vol 23 ◽

pp. S75

Author(s):

S. Pandey ◽

A. Sharma ◽

B. Singh ◽

J. Vanderpuye-Orgle ◽

M.K. Siddiqui

Keyword(s):

Overall Survival ◽

Bayesian Network ◽

Fractional Polynomial ◽

Meta Analyses ◽

Polynomial Methods

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How to read and interpret the results of a Bayesian network meta-analysis: a short tutorial

Animal Health Research Reviews ◽

10.1017/s1466252319000343 ◽

2019 ◽

Vol 20 (2) ◽

pp. 106-115 ◽

Cited By ~ 1

Author(s):

D. Hu ◽

A. M. O'Connor ◽

C. B. Winder ◽

J. M. Sargeant ◽

C. Wang

Keyword(s):

Bayesian Network ◽

Bayesian Approach ◽

Probability Distributions ◽

Meta Analysis ◽

Risk Of Bias ◽

Forest Plot ◽

The Novel ◽

Meta Analyses ◽

Realistic Data

AbstractIn this manuscript we use realistic data to conduct a network meta-analysis using a Bayesian approach to analysis. The purpose of this manuscript is to explain, in lay terms, how to interpret the output of such an analysis. Many readers are familiar with the forest plot as an approach to presenting the results of a pairwise meta-analysis. However when presented with the results of network meta-analysis, which often does not include the forest plot, the output and results can be difficult to understand. Further, one of the advantages of Bayesian network meta-analyses is in the novel outputs such as treatment rankings and the probability distributions are more commonly presented for network meta-analysis. Our goal here is to provide a tutorial for how to read the outcome of network meta-analysis rather than how to conduct or assess the risk of bias in a network meta-analysis.

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A comparison of the effects of electroacupuncture versus transcutaneous electrical nerve stimulation for pain control in knee osteoarthritis: a Bayesian network meta-analysis of randomized controlled trials

Acupuncture in Medicine ◽

10.1177/0964528420921193 ◽

2020 ◽

pp. 096452842092119

Author(s):

Xiaowei Shi ◽

Wenjing Yu ◽

Wei Zhang ◽

Tong Wang ◽

Oyunerdene Battulga ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Bayesian Network ◽

Randomized Controlled Trials ◽

Nerve Stimulation ◽

Pain Control ◽

Transcutaneous Electrical Nerve Stimulation ◽

Controlled Trials ◽

Electrical Nerve Stimulation ◽

Randomized Controlled ◽

Meta Analyses

Background To compare the effectiveness of electroacupuncture (EA) and transcutaneous electrical nerve stimulation (TENS) for pain control in knee osteoarthritis (KOA). Methods Four English (MEDLINE, EMBASE, Cochrane Library and Web of Science) and three Chinese (China Science Journal Citation Report (VIP), Wanfang and China National Knowledge Infrastructure (CNKI)) language databases were searched for eligible randomized controlled trials (RCTs), comparing four approaches: EA, TENS, medication and sham/placebo controls. The primary outcome was pain intensity, measured by visual analogue scale (VAS), numeric-rating scale (NRS) or Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale. Classic pairwise and Bayesian network meta-analyses were conducted to integrate the treatment efficacy/effectiveness through direct and indirect evidence. Results Thirteen studies were included. In the direct meta-analyses, there was no statistically significant overall effect of EA (mean difference (MD) −4.77, 95% confidence interval (CI) −12.51 to 2.96), while the overall effects of high-frequency transcutaneous electrical nerve stimulation (H-TENS) (MD −16.63, 95% CI −24.57 to −8.69) and medication (MD −7.12, 95% CI −12.07 to −2.17) were statistically significant. In the network meta-analyses, the relative effect of the EA and H-TENS groups (MD 5.07, 95% CI −11.33 to 21.93) on pain control did not differ. Meanwhile, H-TENS demonstrated the highest probability of being the first best treatment, and EA had the second highest probability. Conclusion The present analysis indicated that both EA and TENS exert significant pain relieving effects in KOA. Among the four treatments, H-TENS was found to be the optimal treatment choice for the management of KOA pain in the short-term, and EA the second best treatment option. Given that the application of TENS is recommended by various international guidelines for the treatment of KOA, EA may also represent a potentially effective non-pharmacologic therapy.

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Fr522 VALIDATION OF FIRST-LINE AND SECOND-LINE INDUCTION THERAPIES FOR PATIENTS WITH MODERATE TO SEVERELY ACTIVE ULCERATIVE COLITIS USING BAYESIAN NETWORK META-ANALYSES

Gastroenterology ◽

10.1016/s0016-5085(21)01543-2 ◽

2021 ◽

Vol 160 (6) ◽

pp. S-345

Author(s):

Amporn Atsawarungruangkit ◽

Samir A. Shah

Keyword(s):

Ulcerative Colitis ◽

Bayesian Network ◽

Active Ulcerative Colitis ◽

Second Line ◽

First Line ◽

Meta Analyses

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Surgical management of focal chondral defects of the knee: a Bayesian network meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02684-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Filippo Migliorini ◽

Jörg Eschweiler ◽

Hanno Schenker ◽

Alice Baroncini ◽

Markus Tingart ◽

...

Keyword(s):

Bayesian Network ◽

Meta Analysis ◽

Surgical Techniques ◽

Continuous Variables ◽

Surgical Interventions ◽

Bayesian Hierarchical ◽

Chondral Defects ◽

Chondrocyte Implantation ◽

Meta Analyses

Abstract Background Focal chondral defects of the knee are common. Several surgical techniques have been proposed for the management of chondral defects: microfractures (MFX), osteochondral autograft transplantation (OAT), autologous matrix-induced chondrogenesis (AMIC) and autologous chondrocyte implantation (ACI)—first generation (pACI), second generation (cACI) and third generation (mACI). A Bayesian network meta-analysis was conducted to compare these surgical strategies for chondral defects in knee at midterm follow-up. Methods This Bayesian network meta-analysis was conducted according to the PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions. PubMed, Google Scholar, Embase and Scopus databases were accessed in July 2021. All the prospective comparative clinical trials investigating two or more surgical interventions for chondral defects of the knee were accessed. The network meta-analyses were performed through a Bayesian hierarchical random-effects model analysis. The log odds ratio (LOR) effect measures were used for dichotomic variables, while the standardized mean difference (SMD) for the continuous variables. Results Data from 2220 procedures (36 articles) were retrieved. The median follow-up was 36 (24 to 60) months. The ANOVA test found good baseline comparability between symptoms duration, age, sex and body mass index. AMIC resulted in higher Lysholm score (SMD 3.97) and Tegner score (SMD 2.10). AMIC demonstrated the lowest rate of failures (LOR −0.22) and the lowest rate of revisions (LOR 0.89). As expected, MFX reported the lower rate of hypertrophy (LOR −0.17) followed by AMIC (LOR 0.21). No statistically significant inconsistency was found in the comparisons. Conclusion AMIC procedure for focal chondral defects of the knee performed better overall at approximately 3 years’ follow-up.

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Impact of tourniquet during knee arthroplasty: a bayesian network meta-analysis of peri-operative outcomes

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-020-03725-8 ◽

2021 ◽

Author(s):

Filippo Migliorini ◽

Nicola Maffulli ◽

Paolo Aretini ◽

Andromahi Trivellas ◽

Markus Tingart ◽

...

Keyword(s):

Bayesian Network ◽

Knee Arthroplasty ◽

Meta Analysis ◽

Full Time ◽

Bayesian Hierarchical ◽

Operative Outcomes ◽

Duration Of Surgery ◽

Meta Analyses ◽

No Tourniquet

Abstract Introduction The role of tourniquet during knee arthroplasty is controversial. The present study compares various tourniquet protocols using a Bayesian network meta-analysis of peri-operative data. Material and methods The present study was conducted in accordance with the PRISMA extension statement for reporting systematic reviews incorporating network meta-analyses of health interventions. The literature search was conducted in September 2020. All clinical trials investigating the role of tourniquet in knee arthroplasty were considered for inclusion. Methodological quality was assessed using Review Manager 5.3. A Bayesian hierarchical random-effects model analysis was used in all comparisons. Results Ultimately, pooled data from 68 studies (7413 procedures) were analysed. Significant inconsistency was found in the data relating to total estimated blood lost; no assumption could be made on this outcome. Full-time tourniquet resulted in the shortest surgical duration and lowest intra-operative blood lost, in both cases followed by incision-to-suture. The incision-to-suture protocol achieved the smallest drop in haemoglobin during the first 72 h post-operatively and the lowest rate of blood transfusion, both followed by full-time tourniquet. Hospitalisation was shortest in the absence (no-tourniquet) group, followed by the cementation-to-end group. Conclusion For knee arthroplasty, longer tourniquet use is associated with the shorter duration of surgery, lower intra-operative blood lost, lower drops in haemoglobin and fewer transfusion units. The shortest average hospitalisation was associated with no tourniquet use.

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