Network Meta-Analysis and Its Solution by R

Objective To introduce methodology for undertaking a network meta-analysis and its realization in R. Methods By using lme（） function in R, network meta-analysis of randomized controlled trials（RCTs） was used to combine direct and indirect estimates of the effect of three drugs and placebo for mycobacterium avium complex （MAC） in patients infected with the human immunodeficiency virus （HIV） from 5 RCTs. Results All drugs differed from placebo in reducing MAC events from the results of direct and indirect comparisons. Clarithromycin and Azithromycin differed from Rifabutin in reducing MAC events from the results of direct and indirect comparisons respectively. The indirect efficacy of Clarithromycin and Azithromycin had no significance in statistically. Conclusions A network meta-analysis can be used to combine direct and indirect treatment effects in a formal when several treatments are available and not all treatments have been compared directly in some two-armed RCTs.