网络Meta分析在R软件中的实现

目的介绍网络Meta分析方法及其在R软件的实现。方法以实例说明，采用R软件lme（）函数,通过对来自5个预防人类免疫缺陷病毒感染者发生复合鸟分支杆菌感染事件随机对照研究的3种药物和安慰剂进行直接和间接比较，进行网络Meta分析。结果直接和间接比较结果表明，所有药物较之于安慰剂均可以减少人类免疫缺陷病毒感染者出现复合鸟分支杆菌事件发生，克拉霉素和阿奇霉素较之于利福平均可以减少人类免疫缺陷病毒感染者出现复合鸟分支杆菌事件发生；而对无直接比较证据的克拉霉素与阿奇霉素，间接比较结果显示两者差异无统计学意义。结论合并多个干预措施效果和没有所有干预措施直接比较证据时，采用网络Meta分析方法合并直接和间接比较结果是一种正规的方法。

Network Meta-Analysis and Its Solution by R

Objective To introduce methodology for undertaking a network meta-analysis and its realization in R. Methods By using 1me （） function in R, network meta-analysis of randomized controlled trials （RCTs） was used to combine direct and indirect estimates of the effect of three drugs and placebo for mycobacterium avium complex （MAC） in patients infected with the human immunodeficiency virus （HIV） from 5 RCTs. Results All drugs differed from placebo in reducing MAC events from the results of direct and indirect comparisons. Clarithromycin and Azithromyein differed from Rifabutin in reducing MAC events from the results of direct and indirect comparisons respectively. The indirect efficacy of Clarithromycin and Azithromycin had no significance in statistically. Conclusions A network meta-analysis can be used to combine direct and indirect treatment effects in a formal when several treatments are available and not all treatments have been compared directly in some two-armed RCTs.