Simultaneous synthesis of treatment effects and mapping to a common scale: an alternative to standardisation

OBJECTIVE Trials often may report several similar outcomes measured on different test instruments. We explored a method for synthesising treatment effect information both within and between trials and for reporting treatment effects on a common scale as an alternative to standardisation STUDY DESIGN We applied a procedure that simultaneously estimates a pooled treatment effect and the "mapping" ratios between the treatment effects on test instruments in a connected network. Standardised and non-standardised treatment effects were compared. The methods were illustrated in a dataset of 22 trials of selective serotonin reuptake inhibitors against placebo for social anxiety disorder, each reporting treatment effects on between one and six of a total nine test instruments. RESULTS Ratios of treatment effects on different test instruments varied from trial to trial, with a coefficient of variation of 18% (95% credible interval 11-29%). Standardised effect models fitted the data less well, and standardised treatment effects were estimated with less relative precision than non-standardised effects and with greater relative heterogeneity. CONCLUSION Simultaneous synthesis of treatment effects and mapping to a common scale make fewer assumptions than standardising by dividing effects by the sample standard deviation, allow results to be reported on a common scale, and deliver estimates with superior relative precision.