B1454
Title: PALM: Patient-centered treatment ranking via large-scale multivariate network meta-analysis
Authors: Rui Duan - Harvard University (United States) [presenting]
Abstract: The growing number of available treatment options has led to an urgent need for reliable answers when choosing the best course of treatment for a patient. As it is often infeasible to compare a large number of treatments in a single randomized controlled trial, multivariate network meta-analyses (NMAs) are used to synthesize evidence from trials of a subset of the treatments, where both efficacy and safety-related outcomes are considered simultaneously. However, these large-scale multiple-outcome NMAs have created challenges to existing methods due to the increasing complexity of the unknown correlations between outcomes and treatment comparisons. We propose a new framework for PAtient-centered treatment ranking via Large-scale Multivariate network meta-analysis, termed as PALM, which includes a parsimonious modeling approach, a fast algorithm for parameter estimation and inference, a novel visualization tool for presenting multivariate outcomes termed as the origami plot, as well as personalized treatment ranking procedures taking into account the individual's considerations on multiple outcomes. In application to an NMA that compares 14 treatment options for labor induction, we provide a comprehensive illustration of the proposed framework and demonstrate its computational efficiency and practicality, and obtained new insights and evidence to support patient-centered clinical decision-making.
