Path-Based Approach for Detecting and Assessing Inconsistency in Network Meta-Analysis: A Novel Method

Fuente: arXiv
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Main Authors: Tahmasebi, Noosheen R., Davies, Annabel L., Papakonstantinou, Theodoros, Rücker, Gerta, Nikolakopoulou, Adriani
Format: Preprint
Published: 2025
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author Tahmasebi, Noosheen R.
Davies, Annabel L.
Papakonstantinou, Theodoros
Rücker, Gerta
Nikolakopoulou, Adriani
author_facet Tahmasebi, Noosheen R.
Davies, Annabel L.
Papakonstantinou, Theodoros
Rücker, Gerta
Nikolakopoulou, Adriani
contents Network Meta-Analysis (NMA) plays a pivotal role in synthesizing evidence from various sources and comparing multiple interventions. At its core, NMA relies on integrating both direct evidence from head-to-head comparisons and indirect evidence from different paths that link treatments through common comparators. A key aspect is evaluating consistency between direct and indirect sources. Existing methods to detect inconsistency, although widely used, have limitations. For example, they do not account for differences within indirect sources or cannot estimate inconsistency when direct evidence is absent. In this paper, we introduce a path-based approach that explores all sources of evidence without separating direct and indirect. We introduce a measure based on the square of differences to quantitatively capture inconsistency, and propose a Netpath plot to visualize inconsistencies between various paths. We provide an implementation of our path-based method within the netmeta R package. Via application to fictional and real-world examples, we show that our method is able to detect and visualize inconsistency between multiple paths of evidence that would otherwise be masked by considering all indirect sources together. The path-based approach therefore provides a more comprehensive evaluation of inconsistency within a network of treatments.
format Preprint
id arxiv_https___arxiv_org_abs_2506_20364
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Path-Based Approach for Detecting and Assessing Inconsistency in Network Meta-Analysis: A Novel Method
Tahmasebi, Noosheen R.
Davies, Annabel L.
Papakonstantinou, Theodoros
Rücker, Gerta
Nikolakopoulou, Adriani
Methodology
Network Meta-Analysis (NMA) plays a pivotal role in synthesizing evidence from various sources and comparing multiple interventions. At its core, NMA relies on integrating both direct evidence from head-to-head comparisons and indirect evidence from different paths that link treatments through common comparators. A key aspect is evaluating consistency between direct and indirect sources. Existing methods to detect inconsistency, although widely used, have limitations. For example, they do not account for differences within indirect sources or cannot estimate inconsistency when direct evidence is absent. In this paper, we introduce a path-based approach that explores all sources of evidence without separating direct and indirect. We introduce a measure based on the square of differences to quantitatively capture inconsistency, and propose a Netpath plot to visualize inconsistencies between various paths. We provide an implementation of our path-based method within the netmeta R package. Via application to fictional and real-world examples, we show that our method is able to detect and visualize inconsistency between multiple paths of evidence that would otherwise be masked by considering all indirect sources together. The path-based approach therefore provides a more comprehensive evaluation of inconsistency within a network of treatments.
title Path-Based Approach for Detecting and Assessing Inconsistency in Network Meta-Analysis: A Novel Method
topic Methodology
url https://arxiv.org/abs/2506.20364