MATCH-IT: A decision support tool for multiple comparisons presenting data from network meta-analysis to facilitate guideline development

Birk S. Hunskaar, Per O. Løvsletten, Frankie Achille, Anja F. Heen, Thomas Agoritsas, Per O. Vandvik
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引用次数: 0

Abstract

Introduction

Network meta-analysis (NMA) provides unprecedented opportunities to compare multiple treatment options (multiple comparisons) and are increasingly being used to inform clinical practice guidelines. However, the overwhelming amount of data generated from NMAs is challenging to present in comprehensible overviews for end-users, guideline panelists included. Acknowledging these challenges, we developed MATCH-IT—an interactive evidence summary displaying NMA results for multiple comparisons. In this study, we conducted user-testing and further developed MATCH-IT to support guideline panels in moving from NMA evidence to recommendations.

Methods

We user-tested the tool with guideline panelists and observed the use of the tool in panel meetings. User-testing sessions and guideline meetings were recorded, transcribed, and analyzed. The analysis informed the iterative development in the tool.

Results

We included four guideline panels and tested the tool with 15 panelists (four chairs, four methodologists, five clinical experts and two patient partners). User testing revealed both positive aspects and limitations of the tool. Interactivity allowed for dynamic display of the evidence during panels meetings and was highlighted as valuable. Further, participants felt that the tool provided overview of complex evidence, further facilitated by categorization of effects through colour coding. The inclusion of information on burden of treatment was highlighted as relevant and valuable. Regarding limitations, some users had issues discovering the interactive features. Earlier versions of MATCH-IT did not include sufficiently detailed information, such as the imprecision of effect estimates, which the users felt was needed for decision making. These findings led to refinements of the tool, including a new tutorial, inclusion of confidence intervals, and a new layer displaying more detailed information.

Discussion

Our study suggests that MATCH-IT may play a role in facilitating guideline development by easing understanding of NMA evidence and alleviating information overload in guideline panelists.

Abstract Image

MATCH-IT:用于多重比较的决策支持工具,展示网络荟萃分析数据,促进指南制定
引言 网络荟萃分析(NMA)为比较多种治疗方案(多重比较)提供了前所未有的机会,并越来越多地被用于为临床实践指南提供信息。然而,网络荟萃分析产生的数据量巨大,要为最终用户(包括指南专家小组成员)提供可理解的概述具有挑战性。考虑到这些挑战,我们开发了 MATCH-IT--一种交互式证据摘要,用于显示多重比较的 NMA 结果。在本研究中,我们进行了用户测试,并进一步开发了 MATCH-IT,以支持指南小组从 NMA 证据到建议的转变。 方法 我们与指南小组成员一起对该工具进行了用户测试,并在小组会议上观察了该工具的使用情况。我们对用户测试会议和指南会议进行了记录、转录和分析。分析结果为工具的迭代开发提供了依据。 结果 我们纳入了四个指南小组,并与 15 名小组成员(4 名主席、4 名方法论专家、5 名临床专家和 2 名患者合作伙伴)一起测试了该工具。用户测试显示了该工具的积极方面和局限性。互动性允许在专家小组会议期间动态显示证据,并被强调为很有价值。此外,与会者认为该工具提供了对复杂证据的概述,通过颜色编码对效果进行分类,进一步促进了该工具的使用。与会者强调,将治疗负担信息纳入其中具有相关性和价值。关于局限性,一些用户在发现互动功能时遇到了问题。MATCH-IT 的早期版本没有包含足够详细的信息,例如效果估计值的不精确性,而用户认为这正是决策所需要的。这些发现促使我们对工具进行了改进,包括新的教程、置信区间和显示更详细信息的新图层。 讨论 我们的研究表明,MATCH-IT 可简化对 NMA 证据的理解,减轻指南专家小组成员的信息超载,从而在促进指南制定方面发挥作用。
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