The method of network meta-analysis of diagnostic test accuracy is in the exploratory stage. We had explored and introduced several methods of network meta-analysis of diagnostic test accuracy before. Based on example, we introduce ANOVA model for performing network meta-analysis of diagnostic test accuracy step-by-step.
ObjectivesTo investigate sources of evidence of the clinical pathways approved by the Chinese government.MethodsThe approved clinical pathways were obtained from the website of the National Health and Family Planning Commission. Two reviewers independently extracted the basic information, approval date, types of evidence of the clinical pathways and time of evidence. The variance analysis was performed for the diagnosis and treatment parts of clinical pathways and the LSD method was further used for comparison.ResultsThe main types of evidence were guidelines, textbooks, standard indicators and consensus views. Approximately 80% of the pathways cited clinical practice guidelines and 36% cited the textbooks. The median number of evidence for each clinical pathway was 2. Approximately 85% of the evidence could be obtained the time when the evidence published. The average time interval (between the time when the pathways released and the time when the evidence published) was 5.2 years. Specifically, textbooks constituted the largest proportion in all evidence that was over 15 years of time interval. In addition to the textbook comparison standard indicators, there were significant differences in time interval between guidelines or consensus and textbooks or standard indicators.Conclusions The evidence types selection is based on the concept of evidence-based medicine, yet the time span of the referred evidence is larger. Therefore, developing clinical pathways not only need to refer to the latest research evidence comprehensively and enhance transparency of clinical pathways, but also use evidence quality evaluation standards to evaluate and select the referred evidences.
In 2014, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) working group published guidance in BMJ to evaluate the certainty of the evidence (confidence in evidence, quality of evidence) from network meta-analysis. GRADE working group suggested rating the certainty of direct evidence, indirect evidence, and network evidence, respectively. Recently, GRADE working group has published a series of papers to improve and supplement this approach. This paper introduces the frontiers and advancement of GRADE approach to rate the certainty of evidence from network meta-analysis.
Network meta-analysis (NMA) is a method that can compare and rank the effects of different interventions, which plays an important role in evidence translation and evidence-based decision-making. In 2014, the GRADE working group first introduced the GRADE method for NMA evidence certainty grading. Since then, its method system has been gradually supplemented and improved. In recent years, the GRADE working group has further improved the methods for evaluating intransitivity and imprecision in NMA, and made recommendations for the presentation and interpretation of NMA results, forming a complete methodological chain of NMA evidence certainty grading and result interpretation consisting of 6 steps. Our team updated the method system of GRADE applied in NMA with specific cases to provide references for relevant researchers
The overlap of literature in umbrella reviews can affect the reliability and accuracy of research conclusions, leading to results with a higher risk of bias. Therefore, it becomes crucial to assess the degree of overlapping and how to handle it. In order to avoid redundant calculations and reduce the risk of bias, researchers need to quantify the degree of literature overlap and adopt corresponding processing strategies. This paper provides a detailed introduction to the calculation methods of overlapping and different strategies for handling overlapping, aiming to provide a reference and guidance for domestic scholars' understanding and application of this method.
Rapid, living evidence-based points, as a new model promoting the rapid translation of evidence, aim to integrate the current best evidence, clinical status, public/patient preferences and values, and provide concise and practical guidance rapidly to important questions concerned in clinical medicine and public health. This paper introduces the methodological framework for the development of "Rapid, Living Evidence-Based Points" from 4 aspects: initiation and planning, evidence search and review, development, update, publication and dissemination of evidence-based points, in order to provide a reference for domestic scholars in developing rapid, living evidence-based points.