title: Multicriteria benefit-risk assessment using network meta-analysis.
abstract: OBJECTIVE
  To enable multicriteria benefit-risk (BR) assessment of any number of alternative treatments using all available evidence from a network of clinical trials.
  
  
  METHODS
  We design a general method for multicriteria decision aiding with criteria measurements from Mixed Treatment Comparison (MTC) analyses. To evaluate the method, we apply it to BR assessment of four second-generation antidepressants and placebo in the setting of a published peer-reviewed systematic review.
  
  
  RESULTS
  The analysis without preference information shows that placebo is supported by a wide range of possible preferences. Preference information provided by a clinical expert showed that although treatment with antidepressants is warranted for severely depressed patients, for mildly depressed patients placebo is likely to be the best option. It is difficult to choose between the four antidepressants, and the results of the model indicate a high degree of uncertainty.
  
  
  CONCLUSIONS
  The designed method enables quantitative BR analysis of alternative treatments using all available evidence from a network of clinical trials. The preference-free analysis can be useful in presenting the results of an MTC considering multiple outcomes.
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands. g.h.m.van.valkenhoef@rug.nl
authors.forename: Gert
authors.initials: G
authors.lastname: van Valkenhoef
authors.forename: Tommi
authors.initials: T
authors.lastname: Tervonen
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.forename: Bert
authors.initials: B
authors.lastname: de Brock
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Douwe
authors.initials: D
authors.lastname: Postmus
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D001499:Bayes Theorem; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D003657:Decision Making; D003863:Depression / Q000188:drug therapy*; D015340:Epidemiologic Research Design; D006801:Humans; D007255:Information Services; D008432:Mathematical Computing; D015201:Meta-Analysis as Topic; D010919:Placebos; D018570:Risk Assessment / Q000379:methods; D013269:Stochastic Processes; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D010919:Placebos