Evidence map›Paper›PMID 28739577›Full record

ArticleEvidence-based mental health2017

Common pitfalls and mistakes in the set-up, analysis and interpretation of results in network meta-analysis: what clinicians should look for in a published article.

Anna Chaimani, Georgia Salanti, Stefan Leucht, John R Geddes, Andrea Cipriani

Abstract read
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In one paragraph

Article in Evidence-based mental health, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 19 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 19 syntheses or guidelines pooled it.

  1. Pooled it
  2. Which orthodontic retainer provides the best stabilization? : Systematic review and network meta-analysis.Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie · 2026
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  5. Hydrosalpinx treatment before in-vitro fertilization: systematic review and network meta-analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025
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  16. Critical Appraisal of Published Indirect Comparisons and Network Meta-Analyses of Competing Interventions for Multiple Myeloma.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anna ChaimaniDepartment of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Georgia SalantiDepartment of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece.
Stefan LeuchtDepartment of Psychiatry and Psychotherapy, Technische Universitat Munchen, Munich, Germany.
John R GeddesDepartment of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
Andrea CiprianiDepartment of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.ORCID 0000-0001-5179-8321

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSeveral tools have been developed to evaluate the extent to which the findings from a network meta-analysis would be valid; however, applying these tools is a time-consuming task and often requires specific expertise. Clinicians have little time for critical appraisal, and they need to understand the key elements that help them select network meta-analyses that deserve further attention, optimising time and resources. This paper is aimed at providing a practical framework to assess the methodological robustness and reliability of results from network meta-analysis.

methodsAs a working example, we selected a network meta-analysis about drug treatments for generalised anxiety disorder, which was published in 2011 in the

resultsWe reanalysed the 27 studies included in this network following the methods reported in the original article and compared our findings with the published results. We showed how different methodological approaches and the presentation of results can affect conclusions from network meta-analysis. We divided our results into three sections, according to the specific issues that should always be addressed in network meta-analysis: (1) understanding the evidence base, (2) checking the statistical analysis and (3) checking the reporting of findings.

conclusionsThe validity of the results from network meta-analysis depends on the plausibility of the transitivity assumption. The risk of bias introduced by limitations of individual studies must be considered first and judgement should be used to infer about the plausibility of transitivity. Inconsistency exists when treatment effects from direct and indirect evidence are in disagreement. Unlike transitivity, inconsistency can be always evaluated statistically, and it should be specifically investigated and reported in the published paper. Network meta-analysis allows researchers to list treatments in preferential order; however, in this paper we demonstrated that rankings could be misleading if based on the probability of being the best. Clinicians should always be interested in the effect sizes rather than the naive rankings.

Indexed as

Data Interpretation, StatisticalAnxiety DisordersBiomedical ResearchGuidelines as TopicHumansNetwork Meta-Analysis as TopicReproducibility of ResultsAnxiety DisordersClinical TrialsMental Health

Identifiers

PMID28739577
PMCPMC10688544

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.