Network Meta-Analysis of Real-World Evidence: The Challenge of Related Publications

SUMMER 2022, THE EVIDENCE FORUM, WHITE PAPER

Summary

Network meta-analyses (NMAs) of studies generating real-world evidence (RWE) are increasingly recognized as a valuable approach to establish the comparative effectiveness and tolerability of medical interventions in routine clinical practice. Several frameworks exist or are under development to guide the incorporation of RWE data in regulatory or reimbursement filings. Still, there are important methodological challenges that emerge while synthesizing the evidence originating from RWE studies that have not been formally addressed. One key challenge is the potential of related publications being eligible for inclusion in NMAs that are based on the same study, database, or patient cohort.

In this white paper, we:

• Discuss the challenge of including multiple related publications per database in Network meta-analyses of real-world evidence, and the tension between maximizing precision and minimizing bias
• Examine and illustrate approaches for handling these related publications in NMA of RWE
• Provide recommendations for handling related publications in NMAs of RWE to improve internal and external validity in the context of related publications

Authors

Kyle Fahrbach, PhD, Senior Director Statistics, Evidence Synthesis, Modeling and Communication
Evidera, a business of PPD, part of Thermo Fisher Scientific

Marissa Betts, MS, Research Scientist, Evidence Synthesis, Modeling and Communication
Evidera, a business of PPD, part of Thermo Fisher Scientific