Multiple treatment comparison meta-analyses: A step forward into complexity

Edward J. Mills, Nick Bansback, Isabella Ghement, Kristian Thorlund, Steven Kelly, Milo A. Puhan, James Wright

Research output: Contribution to journalArticlepeer-review


The use of meta-analysis has become increasingly useful for clinical and policy decision making. A recent development in meta-analysis, multiple treatment comparison (MTC) meta-analysis, provides inferences on the comparative effectiveness of interventions that may have never been directly evaluated in clinical trials. This new approach may be confusing for clinicians and methodologists and raises specific challenges relevant to certain areas of medicine. This article addresses the methodological concepts of MTC meta-analysis, including issues of heterogeneity, choice of model, and adequacy of sample sizes. We address domain-specific challenges relevant to disciplines of medicine, including baseline risks of patient populations. We conclude that MTC meta-analysis is a useful tool in the context of comparative effectiveness and requires further study, as its utility and transparency will likely predict its uptake by the research and clinical community.

Original languageEnglish (US)
Pages (from-to)193-202
Number of pages10
JournalClinical Epidemiology
Issue number1
StatePublished - 2011


  • Meta-analysis
  • Mixed treatment comparison
  • Multiple treatment comparison
  • Network

ASJC Scopus subject areas

  • Epidemiology


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