Cooperative Oncology Group scale, and the majority had clopidogrel earlier stage disease. The male to female ration was approximately 3:1. In the trials that reported cytogenetic characteristics, each trial had on average 7% of patients with deletion 17p and 22% with deletion 11q.13,17,18 We assigned Jadad scores ranging from 1 to 3. All five RCTs appeared to be adequately randomized, but only the study conducted by Hallek and colleagues specifically described the method of randomization. In the trial conducted by Hillmen and colleagues, the response review chemical catalogs panel was blinded, but none of the trials appeared to be double blinded. Lack of blinding could increase the potential for study bias, especially for the PFS endpoint. The trial conducted by Rai and colleagues did not clearly describe reasons for patientwithdrawal or discuss why certain patients were excluded from outcome evaluations. For this reason, the trial was assigned only one point using the Jadad scoring method.
Simulation results The convergence diagnostic tests showed that the MCMC algorithm reached adequate equilibrium after 90,000 iterations, which indicated that the phospholipases estimated results are derived from an appropriate posterior distribution. The Weibull model was better fit to the data with stronger linearity in the graphical diagnostic plots and had lower DIC values overall. The fixed effect model demonstrated better convergence, smaller standard deviation and Monte Carlo error, narrower credible intervals, and was better fit to the data with a DIC value of 1022, compared to a DIC of 1066 for the random effect model. The fixed effect model may be better fit in this study due to minimal heterogeneity between the trials in the comparison network. Fig. 4 presents hazard rates and 95% credible bounds for each treatment estimated with the fixed effect Weibull model, which describes the probability that a patient on each treatment who has PFS up to a particular time interval will experience disease capecitabine progression or die within that time interval. Based on the model simulation results for the shape and scale parameters, the hazard of disease progression or death for fludarabine and fludarabine with cyclophosphamide appear to be relatively constant while the hazard rates for alemtuzumab, chlorambucil, and the combination fludarabine with cyclophosphamide and rituximab appear to gradually increase over time.
Presents hazard ratios over time with 95% credible bounds of alemtuzumab, fludarabine, FC, and FCR compared to the historical standard of care, chlorambucil, and also the hazard ratio of FCR compared to FC. Due to wide uncertainty, the relative hazard of disease progression or death for each treatment comparison is uncertain. Fig. 6 presents the projected PFS curves for each treatment option and 95% credible bounds. The combination regimen FCR was associated with longest duration of PFS, with the mean estimated to be approximately 76 months. FC was estimated to yield mean PFS of approximately 60 months, fludarabine 38 months, alemtuzumab 24 months, and chlorambucil 23 months. Table 2 summarizes results of the fixed effect Weibull network meta analysis model. Discussion Summary We performed a systematic literature review to identify RCTs of therapy options for symptomatic.