Draw network estimates against a range of little difference

Draws every network estimate of a network meta-analysis with its confidence interval and prediction interval against a range of little difference, whose lower and upper limits the reader can move on their own. Beside each estimate, in words, is what its confidence interval and its prediction interval are compatible with: an important benefit, little difference or an important harm of the first treatment against the second, or more than one of these; and the imprecision and heterogeneity judgments that CINeMA's rules give at these limits.

Usage

cinema_clinical(
  x,
  ...,
  reference = NULL,
  prediction = TRUE,
  title = NULL,
  caption = NULL,
  family = "Lato"
)

Arguments

x: Judgments from cinema_judge() that include a threshold, or a network meta-analysis from netmeta::netmeta(), judged with the arguments in ....
...: When x is a netmeta fit, arguments for cinema_judge(): threshold, the prespecified limits of little difference, which is required, and small_values, order and pooled.
reference: Optionally, one treatment: only its comparisons with the others are drawn, such as every treatment against placebo.
prediction: Draw the prediction intervals, when the model has them.
title, caption: Title above the plot and note below it. A caption you give is added above the default notes.
family: Font family. The package ships Lato and registers it on load.

Value

An object of class cinema_clinical, which prints as an interactive widget. Use graph_widget(), graph_plot() or graph_save() for the widget, a static ggplot or a file. The field readings gives, for each comparison drawn, what its intervals are compatible with and the imprecision and heterogeneity judgments at the prespecified limits.

Details

In the widget, two sliders move the lower and the upper limit; the prespecified limits stay marked with dashed lines and a button returns to them. Every reading, judgment and the summary under the plot follow. Under the estimates, a threshold sensitivity strip for each limit shows, row by row, where each reading changes as that limit moves with the other held where it is: a change of color is a change of reading. Clicking or tapping a strip moves that limit there; the sliders do the same from the keyboard. A switch hides the prediction intervals.

The limits apply to every comparison as written, the first treatment against the second, in the order set by cinema_judge(). A prediction interval shows where the effect in a comparable new setting is expected to lie, not the effect for an individual patient, and with few studies the heterogeneity behind it is poorly estimated. The plot describes what each interval is compatible with; it never calls a comparison equivalent.

Sources

Nikolakopoulou A, Higgins JPT, Papakonstantinou T, et al. CINeMA: an approach for assessing confidence in the results of a network meta-analysis. PLoS Medicine 2020;17(4):e1003082. doi:10.1371/journal.pmed.1003082

Papakonstantinou T, Nikolakopoulou A, Higgins JPT, Egger M, Salanti G. CINeMA: software for semiautomated assessment of the confidence in the results of network meta-analysis. Campbell Systematic Reviews 2020;16:e1080. doi:10.1002/cl2.1080

Papakonstantinou T, Nikolakopoulou A, Rucker G, et al. Estimating the contribution of studies in network meta-analysis: paths, flows and streams. F1000Research 2018;7:610.

Examples

# \donttest{
if (requireNamespace("netmeta", quietly = TRUE) &&
    requireNamespace("meta", quietly = TRUE)) {
  pw <- meta::pairwise(treat = treatment, event = pasi75_r,
                       n = pasi75_n, studlab = study,
                       data = psoriasis_nma, sm = "OR")
  nma <- netmeta::netmeta(pw, common = FALSE)
  cinema_clinical(nma, threshold = c(0.8, 1.25),
                  small_values = "undesirable")
}
# }