Published online Jul 20, 2021. doi: 10.5662/wjm.v11.i4.228
Peer-review started: March 19, 2021
First decision: May 6, 2021
Revised: May 9, 2021
Accepted: May 27, 2021
Article in press: May 27, 2021
Published online: July 20, 2021
Processing time: 121 Days and 12 Hours
A “simplified” figure was proposed in 2011 to summarize the results of controlled trials that evaluate different treatments aimed at the same disease condition. The original criteria for classifying individual binary comparisons included supe
Core Tip: A “simplified” figure was proposed in 2011 to summarize the results of controlled trials that evaluate different treatments aimed at the same disease condition. This graphical tool presents the network geometry along with the results of the analysis. The original criteria for classifying individual binary comparisons (direct or indirect comparisons) did not differentiate between no proof of difference vs proof of no difference. We have therefore updated the criteria employed in the original “simplified” figure to include this differentiation.
- Citation: Fadda V, Bartoli L, Ferracane E, Trippoli S, Messori A. Simplified figure to present direct and indirect comparisons: Revisiting the graph 10 years later. World J Methodol 2021; 11(4): 228-230
- URL: https://www.wjgnet.com/2222-0682/full/v11/i4/228.htm
- DOI: https://dx.doi.org/10.5662/wjm.v11.i4.228
In 2011, Fadda and coworkers published in the BMJ the proposal of a simplified graph that, in the context of a network meta-analysis, presents the results of direct and indirect comparisons[1]. In 2019, another graph with very similar characteristics was proposed by De Vecchis et al[2]. Both of these graphs adopt the symbol “+” for superiority, “-“ for inferiority, and “=” for the remaining cases.
Differentiating between no proof of difference (with P > 0.05) and proof of no difference (with P > 0.05 and Pequivalence < 0.05) is increasingly recognised to be important[3]; the same applies to differentiation between no proof of difference and proof of non-inferiority (with P > 0.05 and Pnon-inferiority < 0.05, respectively). Since the two graphs of Fadda et al[1] and De Vecchis et al[2] do not include this differentiation, we propose to limit the symbol “=” to cases of equivalence and to adopt the symbol “NI” for non-inferiority or “ND” for the remaining cases. The suffix “t” remains useful because it identifies cases where the binary comparison shows a trend in favour of a treatment though in the absence of a statistically significant difference.
An example of the revisited graph is presented in Figure 1 that compares three first line treatments in paroxysmal atrial fibrillation[4-8].
In the field of network meta-analysis, the issue of graphical communication is complex, and the debate is still ongoing[9-15]. While the objective of describing the network geometry is quite straightforward[9,10], communication becomes more complex when it comes to presenting the results of the analysis[11-15]. The graphical proposal described herein is aimed at presenting the network geometry along with the results of the analysis. In our view, despite some unavoidable aspects of complexity, this tool deserves to be used particularly when the number of comparators is small.
Manuscript source: Unsolicited manuscript
Specialty type: Health care sciences and services
Country/Territory of origin: Italy
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P-Reviewer: Tsikopoulos K S-Editor: Ma YJ L-Editor: Filipodia P-Editor: Wang LYT
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