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Multitreatment comparison meta-analysis: promise and peril
  1. Denise Campbell-Scherer
  1. Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada
  1. Correspondence to: Dr Denise Campbell-Scherer
    , Department of Family Medicine, University of Alberta, Suite 205 College Plaza, 8215 112 Street, Edmonton, Alberta, Canada T6K 4C1; denise.campbell-scherer{at}

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The multiple treatment comparison meta-analysis (MTC-MA) by Cahill et al1 described in this issue2 focuses on pharmacological interventions for smoking cessation. This MTC-MA provides a reminder of how useful this methodological approach can be.

The efficacy of treatments for tobacco dependence is an excellent question for MTC-MA as smoking is prevalent and is a critical risk factor for many diseases with high morbidity and mortality; there is clinical interest in the relative efficacy of pharmacological interventions to aid cessation and direct head-to-head comparisons between each pair of interventions do not exist. Comparisons not based on direct research evidence are referred to as ‘indirect comparisons’.

MTC-MA, also known as network meta-analysis, creates a network in which each node is a different intervention. MTC-MA provides a measure of treatment effect between all pairs of possible interventions in the network, including both direct and indirect comparisons, based on the existing data from controlled pair-wise comparisons in clinical trials.3

Practical interest in indirect comparisons has led to the development of rigorous approaches to conducting MTC-MA, and they are appearing more frequently in the clinical literature. An excellent summary for clinicians of how to use MTC-MA has been published recently in JAMA.4 Awareness of the criteria to look …

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