How to use an article reporting a multiple treatment comparison meta-analysis

Edward J. Mills, John P A Ioannidis, Kristian Thorlund, Holger J. Schünemann, Milo A. Puhan, Gordon H. Guyatt

Research output: Contribution to journalArticlepeer-review

269 Scopus citations


Multiple treatment comparison (MTC) meta-analysis uses both direct (head-to-head) randomized clinical trial (RCT) evidence as well as indirect evidence from RCTs to compare the relative effectiveness of all included interventions. The methodological quality of MTCs may be difficult for clinicians to interpret because the number of interventions evaluated may be large and the methodological approaches may be complex. Clinicians and others evaluating an MTC should be aware of the potential biases that can affect the interpretation of these analyses. Readers should consider whether the primary studies are sufficiently homogeneous to combine; whether the different interventions are sufficiently similar in their populations, study designs, and outcomes; and whether the direct evidence is sufficiently similar to the indirect evidence to consider combining. This article uses the existing Users'Guides format to address study validity, interpretation of results, and application to a patient scenario.

Original languageEnglish (US)
Pages (from-to)1246-1253
Number of pages8
JournalJournal of the American Medical Association
Issue number12
StatePublished - Sep 19 2012

ASJC Scopus subject areas

  • General Medicine


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