multinma: A Package for Network Meta-Analysis of Individual and Aggregate Data in Stan
An R package for performing network meta-analysis and network meta-regression with aggregate data, individual patient data, or mixtures of both. package
Network meta-analysis (NMA) combines (aggregate) data from multiple studies on multiple treatments in order to produce consistent estimates of relative treatment effects between each pair of treatments in the network \insertCite TSD2multinma.
Network meta-regression (NMR) extends NMA to include covariates, allowing adjustment for differences in effect-modifying variables between studies \insertCite TSD3multinma. NMR is typically performed using aggregate data (AgD), which lacks power and is prone to ecological bias. NMR with individual patient data (IPD) is the gold standard, if data are available.
Multilevel network meta-regression (ML-NMR) allows IPD and AgD to be incorporated together in a network meta-regression \insertCite methods_paper,Phillippo_thesismultinma. As in IPD NMR, an individual-level regression model is defined. AgD studies are then fitted by integrating the individual-level model over the respective covariate distributions. This correctly links the two levels of the model (instead of "plugging in" mean covariate values), avoiding aggregation bias. Population-adjusted treatment effects \insertCite TSD18multinma can be produced for any study population in the network, or for an external target population.
Models are estimated in a Bayesian framework using Stan \insertCite Carpenter2017multinma. Quasi-Monte Carlo numerical integration based on Sobol' sequences is used for the integration in ML-NMR models, with a Gaussian copula to account for correlations between covariates \insertCite methods_paper,Phillippo_thesismultinma.
A good place to start is with the package vignettes which walk through example analyses, see vignette("vignette_overview") for an overview. The series of NICE Technical Support Documents on evidence synthesis gives a detailed introduction to network meta-analysis:
\insertRef TSD_evsynthmultinma
Multilevel network meta-regression is set out in the following methods paper:
\insertRef methods_papermultinma
\insertAllCited
Useful links:
Maintainer : David M. Phillippo david.phillippo@bristol.ac.uk (ORCID)
Other contributors:
Useful links