Cochrane Handbook for Systematic Reviews of Interventions
Chapter 11: Undertaking network meta-analyses

Anna Chaimani, Deborah M Caldwell, Tianjing Li, Julian PT Higgins, Georgia Salanti

This is a draft version of this chapter and is subject to change before finalization. It is made available for personal use of Cochrane members only, and is not for general distribution. All content remains the copyright of Cochrane.

To cite this draft chapter, please use:

Chaimani A, Caldwell DM, Li T, Higgins JPT, Salanti G. Chapter 11: Undertaking network meta-analyses. Draft version (16 September 2018) for inclusion in: Higgins JPT, Thomas J, Chandler J, Cumpston MS, Li T, Page MJ, Welch V (editors). Cochrane Handbook for Systematic Reviews of Interventions. London: Cochrane.

Copyright © 2018 The Cochrane Collaboration.

Key Points

  • Network meta-analysis is a technique for comparing three or more interventions simultaneously in a single analysis by combining both direct and indirect evidence across a network of studies. 
  • Network meta-analysis allows for estimating the relative effects between any pairs of interventions in the network and usually yields more precise estimates than a single direct or indirect estimate. It also allows for the estimation of the ranking and hierarchy of interventions.
  • A valid network meta-analysis relies on the assumption that the different sets of studies included in the analysis are similar, on average, in all important factors that may affect the relative effects. 
  • Incoherence (also called inconsistency) occurs when different sources of information (e.g. direct and indirect) for a relative effect disagree.
  • Grading the confidence in the evidence in a network meta-analysis begins by evaluating each risk of bias domain for each direct comparison. Then the domain-specified assessments are combined to determine the overall confidence in the evidence.
Section info
Change date
14 March 2019