Network meta-regression including baseline risk analysis and interactive visualisations as implemented by the MetaInsight web application.

Abstract

Background and objectives: The MetaInsight web application (https://apps.crsu.org.uk/MetaInsight) allows users to carry out network meta-analyses (NMA) via a point-and-click interface, without the need for statistical programming. Network meta-regression (NMR) is an extension of NMA that adds covariates to the model and is used to investigate heterogeneity and inconsistency within the network. Specifically, NMR allows users to explore the interaction between treatment and study-level covariates. The aim of this paper is to describe the implementation and application of NMR in MetaInsight, for a single covariate, which may be a study-level variable or baseline risk with the uncertainty in the latter correctly accounted for.

Methods: NMR has been added to MetaInsight using the R packages gemtc and bnma. The type of regression coefficients fitted can be set to shared, exchangeable or unrelated relating to whether the same or different relationships are assumed between the covariate and each treatment. A graph has been added to show the distribution of covariate values, and a novel visualisation has been developed to show which studies contribute to which comparisons, for multiple comparisons simultaneously.

Results: The new functionality is described and illustrated with an example, and screenshots of the app are included.

Conclusion: This extensive update of the app greatly facilitates such complex analyses making them freely accessible to researchers from a wide range of backgrounds. This in turn should improve the reporting and reliability of published NMA which ultimately should positively impact clinical decision making.