Combining Pharmacological and Nonpharmacological Interventions in Network Meta-analysis in Psychiatry

Abstract

Network meta-analyses (NMAs) assess the comparative associations of 2 or more interventions even if they have not been compared in a randomized clinical trial.1 The validity of NMAs is founded on the assumption of transitivity (ie, that effect modifiers do not substantially differ across the included trials).1 The popularity of NMAs on pharmacological or nonpharmacological interventions is increasing in psychiatry.2 Recent NMAs have combined pharmacological and nonpharmacologic interventions in the same network. Although this may be informative for developing guidelines, it is methodologically challenging and could compromise the validity of NMAs. We aimed to evaluate NMAs that combined pharmacological and nonpharmacological interventions and provide guidance on how to conduct them.