Additional considerations are required when preparing a protocol for a systematic review with multiple interventions

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

Research output: Contribution to journalArticle (Academic Journal)peer-review

92 Citations (Scopus)
508 Downloads (Pure)


Objectives: The number of systematic reviews that aim to compare multiple interventions using network meta-analysis is increasing. In this paper, we highlight aspects of a standard systematic review protocol that may need modification when multiple interventions are to be compared.
Study Design and setting: We take the protocol format suggested by Cochrane for a standard systematic review as our reference, and compare the considerations for a pairwise review with those required for a valid comparison of multiple interventions. We suggest new sections for protocols of systematic reviews including network meta-analyses with a focus on how to evaluate their
assumptions. We provide example text from published protocols to exemplify the considerations.

Results and Conclusion: Standard systematic review protocols for pairwise meta-analyses need extensions to accommodate the increased complexity of network meta-analysis. Our suggested modifications are widely applicable to both Cochrane and non-Cochrane systematic reviews involving network meta-analyses.
Original languageEnglish
Pages (from-to)65–74
Number of pages10
JournalJournal of Clinical Epidemiology
Early online date11 Jan 2017
Publication statusPublished - Mar 2017


  • comparative effectiveness review
  • eligibility criteria
  • transitivity
  • network meta-analysis
  • indirect comparison
  • mixed treatment comparison


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  • Research Fellowship

    Caldwell, D.


    Project: Research

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