A criterion-based approach to systematic and transparent comparative effectiveness: a case study in psoriatic arthritis.
Tremblay, Gabriel;
Westley, Tracy;
Forsythe, Anna;
Pelletier, Corey;
Briggs, Andrew;
(2019)
A criterion-based approach to systematic and transparent comparative effectiveness: a case study in psoriatic arthritis.
Journal of comparative effectiveness research, 8 (15).
pp. 1265-1298.
ISSN 2042-6305
DOI: https://doi.org/10.2217/cer-2019-0064
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Aim: Indirect treatment comparisons are used when no direct comparison is available. Comparison networks should satisfy the transitivity assumption, that is, equal likelihood of treatment assignment for a given patient based on comparability of studies. Materials & methods: Seven criteria were evaluated across 18 randomized controlled trials in psoriatic arthritis: inclusion/exclusion criteria, clinical trial design and follow-up, patient-level baseline characteristics, disease severity, prior therapies, concomitant and extended-trial treatment and placebo response differences. Results: Across studies, placebo was a common comparator, and key efficacy end points were reported. Collectively, several potential sources of insufficient transitivity were identified, most often related to trial design and population differences. Conclusion: Potential challenges in satisfying transitivity occur frequently and should be evaluated thoroughly.