Vitruvian plot: a visualisation tool for multiple outcomes in network meta-analysis

Author:

Ostinelli Edoardo GiuseppeORCID,Efthimiou OrestisORCID,Naci Huseyin,Furukawa Toshi AORCID,Leucht StefanORCID,Salanti GeorgiaORCID,Wainwright Laurence,Zangani Caroline,De Crescenzo FrancoORCID,Smith Katharine,Stevens Katherine,Liu Qiang,Cipriani AndreaORCID

Abstract

ObjectiveA network meta-analysis (NMA) usually assesses multiple outcomes across several treatment comparisons. TheVitruvian plotaims to facilitate communication of multiple outcomes from NMAs to patients and clinicians.MethodsWe developed this tool following the recommendations on the communication of benefit–risk information from the available literature. We collected and implemented feedback from researchers, statisticians, methodologists, clinicians and people with lived experience of physical and mental health issues.ResultsWe present theVitruvian plot, which graphically presents absolute estimates and relative performance of competing interventions against a common comparator for several outcomes of interest. We use two alternative colour schemes to highlight either the strength of statistical evidence or the confidence in the evidence. Confidence in the evidence is evaluated across six domains (within-study bias, reporting bias, indirectness, imprecision, heterogeneity and incoherence) using the Confidence in Network Meta-Analysis (CINeMA) system.ConclusionsTheVitruvian plotallows reporting of multiple outcomes from NMAs, with colourings appropriate to inform credibility of the presented evidence.

Funder

Swiss National Science Foundation

National Institute for Health Research

Applied Research Collaboration

NIHR Oxford cognitive health Clinical Research Facility

Biomedical Research Centre

Publisher

BMJ

Subject

Psychiatry and Mental health

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