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Network Meta-analysis — SCE Medical Oncology MCQ

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HardClinical Trials & StatisticsNetwork Meta-analysisSCE Medical Oncology

Trials compare A with C and B with C, but no trial compares A with B. A network meta-analysis will estimate A versus B indirectly. Which assumption is most important for that indirect estimate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Treatment-effect modifiers are sufficiently similar across the A-C and B-C trial sets to support transitivity

Explanation lettering: B = shown as A · E = shown as B · A = shown as E

E is correct. Transitivity requires that participants in the different comparisons could, in principle, have been randomised to any of the network treatments and that important effect modifiers are similarly distributed. Otherwise C is not a valid bridge between A and B. A does not require identical event counts or follow-up. B confuses balance with validity. C treats a ranking as evidence and ignores its uncertainty. D describes network connectivity but discards consistency assessment; where direct and indirect evidence coexist, incoherence must be examined. A network meta-analysis expands comparisons but does not manufacture exchangeability.

Reference: NICE guideline manual Appendix K: network meta-analysis reporting: https://www.nice.org.uk/guidance/pmg20/resources/developing-nice-guidelines-the-manual-appendices-2549710189/chapter/Appendix-K-Network-meta-analysis-reporting-standards