Using indirect comparisons to compare interventions within a Cochrane review: a tool for comparative effectiveness research

Author:

Agapova Maria1,Devine Emily B123,Nguyen Hiep1,Wolf Fredric M234,Inoue Lurdes YT5

Affiliation:

1. Pharmaceutical Outcomes Research & Policy Program, University of Washington, Box 357630, Seattle, WA 98195-7630, USA

2. Department of Biomedical Informatics & Medical Education, University of Washington, Box 358047, Seattle, WA 98195-7630, USA

3. Department of Health Services, University of Washington, Box 357162, Seattle, WA 98195-7630, USA

4. Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195-7630, USA

5. Department of Biostatistics, University of Washington, Box 357232, Seattle, WA 98195-7630, USA

Abstract

Aim: Assessing relative performance among competing interventions is an important part of comparative effectiveness research. Bayesian indirect comparisons add information to existing Cochrane reviews, such as which intervention is likely to perform best. However, heterogeneity variance priors may influence results and, potentially, clinical guidance. Methods: We highlight the features of Bayesian indirect comparisons using a case study of a Cochrane review update in asthma care. The probability that one self-management educational intervention outperforms others is estimated. Simulation studies investigate the effect of heterogeneity variance prior distributions. Results: Results suggest a 55% probability that individual education is best, followed by combination (39%) and group (6%). The intervention with few trials was sensitive to prior distributions. Conclusion: Bayesian indirect comparisons updates of Cochrane reviews are valuable comparative effectiveness research tools.

Publisher

Future Medicine Ltd

Subject

Health Policy

Reference59 articles.

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3. Principles for planning and conducting comparative effectiveness research

4. Agency for Healthcare Research and Quality. Methods Reference Guide for Effectiveness and Comparative Effectiveness Review 2012. http://effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?productid=318&pageaction=displayproduct 

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