Review of mixed treatment comparisons in published systematic reviews shows marked increase since 2009

J Clin Epidemiol. 2014 Feb;67(2):138-43. doi: 10.1016/j.jclinepi.2013.07.014. Epub 2013 Oct 3.


Objectives: To identify and summarize published systematic reviews that report results of meta-analyses that combined direct and indirect comparisons.

Study design and setting: Narrative review of mixed treatment comparisons (MTCs) reported in systematic reviews of health interventions. MEDLINE, MEDLINE In-Process, Embase, CINAHL, DARE, the Cochrane Database of Systematic Reviews, and SIGLE were searched for reviews published up to June 2012 in which a meta-analysis had been conducted that combined direct and indirect comparisons among more than two interventions.

Results: Reviews reporting MTCs are difficult to identify when searching major databases. These databases offer no way to identify MTCs, and authors use various names when reporting them. Of the 201 eligible reviews identified, more than three-quarters had been published in full. MTC methods have been used to study a wide range of clinical topics. The reported use of these methods has increased rapidly since 2009, and results from MTCs are commonly used in health policy decisions, through the evidence considered in health technology assessments.

Conclusion: In view of the increasing use of MTCs, indexing of this study type in databases and a consensus on terminology and standards for conduct and reporting would be timely.

Keywords: Evidence-based medicine; Indirect comparison; Meta-analysis; Mixed treatment comparison; Research design/trends; Review literature.

Publication types

  • Review

MeSH terms

  • Clinical Protocols / standards*
  • Data Interpretation, Statistical
  • Evidence-Based Medicine / methods
  • Evidence-Based Medicine / standards*
  • Humans
  • Meta-Analysis as Topic*
  • Models, Theoretical
  • Research Design
  • Systematic Reviews as Topic*