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Meta-Review: Network Meta-Analyses in Child and Adolescent Psychiatry.
Journal of the American Academy of Child and Adolescent Psychiatry ( IF 13.3 ) Pub Date : 2018-10-16 , DOI: 10.1016/j.jaac.2018.07.891
Samuele Cortese 1 , Anneka Tomlinson 2 , Andrea Cipriani 3
Affiliation  

OBJECTIVE Network meta-analyses (NMAs) are gaining traction as the preferred method for evidence synthesis of intervention studies. This review aimed to summarize the basics of NMAs and conduct a meta-review of available NMAs on the treatment of child and adolescent psychiatric disorders by appraising their quality. METHOD PubMed (Medline), PsycInfo, Embase, Ovid Medline, and Web of Knowledge were systematically searched (last update January 9, 2018). The quality of each included NMA was appraised using the AMSTAR-2 tool and the PRISMA-NMA checklist, which includes specific items for NMAs. RESULTS Eighteen NMAs (6 on attention-deficit/hyperactivity disorder; 4 on psychotic disorders; 2 on depression; 2 on anxiety disorders; 1 on obsessive-compulsive disorder; 1 on disruptive behavior disorder, 1 on bipolar disorder, and 1 on antipsychotics across disorders) were retrieved. Results from the AMSTAR-2 assessment showed that only 27% of appraised NMAs were rated as moderate quality; most were rated as low (33%) or critically low (40%) quality. Only 3 of the appraised NMAs reported on all PRISMA-NMA items specific for NMAs; the network structure was graphically presented in most NMAs (80%), and inconsistency was described in only 47%. CONCLUSION Given the paucity of head-to-head trials in child and adolescent psychiatry, NMAs have the potential to contribute to the field, because they provide evidence-based hierarchies for treatment decision making, even in the absence of trials directly comparing at least 2 treatments. However, because of important limitations in the included NMAs, additional methodologically sound NMAs are needed to inform future guidelines and clinical practice in child and adolescent psychiatry.

中文翻译:

荟萃审查:儿童和青少年精神病学中的网络荟萃分析。

目标网络荟萃分析(NMA)作为干预研究证据综合的首选方法越来越受到关注。这篇综述旨在总结NMA的基础知识,并通过评估其质量来对可用的NMA进行儿童和青少年精神病治疗的元回顾。方法系统搜索PubMed(Medline),PsycInfo,Embase,Ovid Medline和Web of Knowledge(最新更新于2018年1月9日)。使用AMSTAR-2工具和PRISMA-NMA检查表对每个包含的NMA的质量进行了评估,其中包括NMA的特定项目。结果18例NMA(6例是注意力缺陷/多动障碍; 4例是精神病性障碍; 2例是抑郁症; 2例是焦虑症; 1例是强迫症; 1例是破坏性行为障碍; 1例是双相情感障碍,另有1篇关于跨疾病的抗精神病药)。AMSTAR-2评估的结果表明,只有27%的评估NMA被评为中等质量;多数被评为低(33%)或极低(40%)质量。被评估的NMA中只有3个报告了针对NMA的所有PRISMA-NMA项目;大多数NMA(80%)以图形方式显示了网络结构,只有47%的人描述了不一致。结论鉴于在儿童和青少年精神病学方面的头对头试验很少,因此NMA有潜力为该领域做出贡献,因为即使在没有试验直接比较至少2项试验的情况下,它们也为治疗决策提供了基于证据的层次结构。治疗。但是,由于所包含的NMA的重要限制,
更新日期:2018-10-16
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