Guidance for evaluating the quality of network meta-analyses published in the BMJ

The British Medical Journal has published a paper led by Milo Puhan that presents guidance for how to evaluate the quality of evidence of network meta-analyses. This paper is the result of an effort by the GRADE Working Group that began in 2010. The paper presents a four-step approach to rate the quality of evidence in each of the direct, indirect, and network meta-analytic estimates and shows that the quality of evidence supporting NMA estimates varies from high to very low across comparisons, and that quality ratings given to a whole network are uninformative and likely to mislead.

Walter Schmid