Linear mixed model approach to network meta-analysis for continuous outcomes in periodontal research

J Clin Periodontol. 2015 Feb;42(2):204-12. doi: 10.1111/jcpe.12362. Epub 2015 Feb 2.

Abstract

Aim: Analysing continuous outcomes for network meta-analysis by means of linear mixed models is a great challenge, as it requires statistical software packages to specify special patterns of model error variance and covariance structure. This article demonstrates a non-Bayesian approach to network meta-analysis for continuous outcomes in periodontal research with a special focus on the adjustment of data dependency.

Data: Seventeen studies on guided tissue regeneration were used to illustrate how the proposed linear mixed models for network meta-analysis of continuous outcomes.

Methods & results: Arm-based network meta-analysis use treatment arms from each study as the unit of analysis; when patients are randomly assigned to each arm, data are deemed independent and therefore no adjustment is required for multi-arm trials. Trial-based network meta-analysis use treatment contrasts as the unit of analysis, and therefore treatment contrasts within a multi-arm trial are not independent. This data dependency occurs also in split-mouth studies, and adjustments for data dependency are therefore required.

Conclusions: Arm-based analysis is the preferred approach to network meta-analysis, when all included studies use the parallel group design and some compare more than two treatment arms. When included studies used designs that yield dependent data, the trial-based analysis is the preferred approach.

Keywords: guided tissue regeneration; linear mixed model; mixed treatments comparisons; network meta-analysis; randomized controlled trials.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Dental Research / statistics & numerical data*
  • Guided Tissue Regeneration, Periodontal / statistics & numerical data
  • Humans
  • Linear Models*
  • Meta-Analysis as Topic*
  • Periodontics / statistics & numerical data*
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Research Design / statistics & numerical data
  • Review Literature as Topic
  • Treatment Outcome*