Title: Method Meta-analysis
Funder: Medical Research Council

Abstract: Systematic review and meta-analysis are essential tools for rigorously evaluating the effects of therapies, particularly integrating our trial results with those of other groups, and informing the design of our trials. This programme develops the methodology underpinning systematic reviews and meta-analyses, applies it in high-quality reviews relevant to our trials, and disseminates it to the scientific community. Interaction between systematic reviewers, methodologists and trialists is fundamental to these endeavours. We have particular experience and an international reputation in the conduct of large collaborative systematic reviews and meta-analyses based individual participant data (IPD). Over more than 20 years, these have influenced the treatment of patients globally, and moreover, the data have been used to investigate methodological issues and develop robust solutions. However, such IPD meta-analyses are time- and resource-intensive, so a key aim is to establish when they are most needed to answer clinical questions reliably. Conversely, if aggregate data approaches are to provide a robust and speedier alternative, we need to move beyond the current methods of doing these, in order to limit the inherent biases. With some clinical areas moving rapidly, there can be multiple trials comparing different treatments to one or more standard. This means that there is sometimes little opportunity for direct comparisons, so we also need the most robust and timely methods for network meta-analysis. We refer to pairwise meta-analysis (directly comparing two treatments) as MA and network meta-analysis (directly and indirectly comparing many treatments) as NMA. In this area, we benefit from the arrival of new senior staff in 2017, which has substantially broadened our expertise in statistical modelling for MA and NMA. Our future plans will continue to integrate this expertise into our ongoing programme of work. For example, we will develop and implement state-of-the-art methodology in MA and NMA of time-to-event outcomes based on individual participant data (IPD), informing overall and stratified treatment decisions, while allowing for complexities in the design of the component trials, heterogeneity between trials, and inconsistency between direct and indirect evidence. Our overall philosophy is to use the simplest methods that can be shown to be valid (often by methodological comparison with more complex methods), and wherever possible to work prospectively and collaboratively to reduce bias, increase the timeliness of our reviews, and achieve greater impact. Our research covers four priority areas: 1. Beyond standard systematic reviews – developing review methods that move beyond standard approaches and using them to perform high-quality and challenging reviews 2. Determining methods to assess which participants benefit most from treatments in pairwise and network meta-analysis 3. Choosing and building appropriate models for in pairwise and network meta-analysis 4. Guidance and tools to increase impact of our meta-analysis methods


Research activity codes: 6.9 RESOURCES AND INFRASTRUCTURE (TREATMENT EVALUATION)
Health categories: GENERIC HEALTH RELEVANCE