网状Meta分析证据确信度分级与结果解读:方法与案例

Evidence certainty grading of network meta-analysis:method update and case application

网状Meta分析(network meta-analysis,NMA)能够实现对不同干预措施效果的比较和排序,在证据转化与循证决策中具有重要作用。2014年,GRADE工作组首次介绍了NMA证据确信度分级的GRADE方法,此后其方法体系逐步得到补充和完善,笔者团队于2020年也对相关前沿和进展进行了介绍。近年来,GRADE工作组进一步完善了NMA中对不可传递性和不精确性的评价方法,并针对NMA结果的呈现和解读作出推荐,形成由6个步骤组成的NMA证据确信度分级与结果解读的完整方法学链条。鉴于此,本团队结合具体案例,对GRADE在NMA中应用的方法体系进行更新,以期为相关研究人员提供参考。

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 has 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.