How to do multiple treatment meta-analysis?

I would like to compare 3 different treatments (no one treatment is considered the placebo, and these are not randomized control trials) from multiple studies in a meta-analysis. I am using the software called "Review Manager" from the Cochrane society, and I am wondering if what I am doing is correct or not:

Say A, B, and C are the different treatments. I make the direct comparisons A vs. B, A vs. C, and B and C to obtain the odds ratios, confidence intervals, Z scores, p values, etc. Then I use the results from A vs. B and A vs. C to calculate the indirect comparison for B vs. C, obtaining the odds ratio and SE.

A vs. B Ignore where it says risk ratio, the studies that I will be looking at are all retrospective.

A vs. C Ignore where it says risk ratio, the studies that I will be looking at are all retrospective.

I make another analysis with both direct and indirect B vs. C on Review Manager to obtain the odds ratio and statistics for this.

Direct and Indirect B vs. C Ignore where it says risk ratio, the studies that I will be looking at are all retrospective.

Indirect B vs. C was determined using:

L or l = log

Please tell me if I am doing this correctly, and whether if this is valid.

If so, how would I report the results from the analysis between the direct and indirect B vs. C? This would be telling me whether if the difference between B and C is significant?

How would I report the overall findings comparing the 3 different treatments?

Thanks for the help!

• are you trying to perform a network meta-analysis? bmj.com/content/346/bmj.f2914 Mar 10, 2014 at 14:25
• In your third figure, how did you come up with RR=0.42 for the indirect comparison of B vs C? Mar 11, 2014 at 9:21
• @charles Yes, I am trying to perform a network meta-analysis.
– JC22
Mar 11, 2014 at 15:14
• @Wolfgang I've added the calculations above for indirect B vs C
– JC22
Mar 11, 2014 at 15:17
• What you are doing is correct but I haven't recalculated them to check your math. This is called the 'Bucher Method' or 'adjusted indirect comparison'. It can be done in a network meta-analysis (or multiple treatment comparison), but also as you have done using GIV to pool the direct and indirect estimates. Mar 11, 2014 at 16:15