Bias in identification of the best treatment in a Bayesian network meta-analysis for binary outcome: a simulation study
Bibliographic record
Abstract
Network meta-analysis (NMA) has emerged as a useful analytical tool allowing comparison of multiple treatments based on direct and indirect evidence. Commonly, a hierarchical Bayesian NMA model is used, which allows rank probabilities (the probability that each treatment is best, second best, and so on) to be calculated for decision making. However, the statistical properties of rank probabilities are not well understood. This study investigates how rank probabilities are affected by various factors such as unequal number of studies per comparison in the network, the sample size of individual studies, the network configuration, and effect sizes between treatments. In order to explore these factors, a simulation study of four treatments (three equally effective treatments and one less effective reference) was conducted. The simulation illustrated that estimates of rank probabilities are highly sensitive to both the number of studies per comparison and the overall network configuration. An unequal number of studies per comparison resulted in biased estimates of treatment rank probabilities for every network considered. The rank probability for the treatment that was included in the fewest number of studies was biased upward. Conversely, the rank of the treatment included in the most number of studies was consistently underestimated. When the simulation was altered to include three equally effective treatments and one superior treatment, the hierarchical Bayesian NMA model correctly identified the most effective treatment, regardless of all factors varied. The results of this study offer important insight into the ability of NMA models to rank treatments accurately under several scenarios. The authors recommend that health researchers use rank probabilities cautiously in making important decisions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.188 | 0.336 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.012 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.004 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".