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The SACS, in particular, lacked both the human resources and the skills needed to manage such programs, particularly as delivered by a network of intervention units.
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Figure 1 shows the network of interventions.
In our meta-analysis, the main scaffold of the evidence base is a star-shaped network of interventions with usual care/placebo as the "golden common comparator", with which single interventions are contrasted.
In Gujarat, there are several examples of efforts to link interventions on maternal healthcare to each in a way that they support and develop the comprehensive network of interventions needed to provide maternal healthcare.
To inform the simulation scenarios we use a large collection of complex networks of interventions [ 14].
Reliable estimation of different heterogeneity parameters will require a minimum number of studies for each comparison, a scenario which seldom occurs in published networks of interventions.
Our previous empirical study showed that a large majority (85%) of published networks of interventions involve trials with multiple arms, and that out of the total 1173 trials included in all 40 networks 116 (10%) were multi-arm trials.
The simulation scenarios are informed by two previous empirical studies; a large collection of 303 loops from published networks of interventions [ 14] and a study about the empirical distribution of heterogeneity on dichotomous outcomes [ 22].
Further research will be necessary though to establish the benefits of IPD in various settings, as well as the properties of the IPD-NMA models in networks of interventions with complex evidence structure.
In the scenario where all direct pair-wise comparisons involve a common comparator (corresponding to star-shaped networks of interventions), they found the results of these two approaches to be similar.
Although the performance of the z-test for inconsistency might vary according to the method used to estimate the uncertainty of the overall mean treatment effect, the power remains generally low for the loop of evidence that typically features in networks of interventions.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com