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Table 1 Advantages and disadvantages of incorporating both randomized controlled trials and non-randomized comparative cohort studies in network meta-analysis

From: Network meta-analysis incorporating randomized controlled trials and non-randomized comparative cohort studies for assessing the safety and effectiveness of medical treatments: challenges and opportunities

Advantages
• Non-randomized studies can complement randomized controlled trials or address some of their limitations, such as short follow-up time, small sample size, highly selected population, high cost, and ethical restrictions.
• Incorporating both types of data allows assessments of multiple treatments simultaneously, including treatments that may not have been studied in randomized controlled trials.
• Incorporating both types of data allows larger sample size and more diverse populations, thereby improving the generalizability of the findings.
• Incorporating non-randomized studies might improve network density and connect disconnected networks.
Disadvantages
• Including low-quality, non-randomized comparative cohort studies could perpetuate the biases that are unknown, unmeasured, or uncontrolled.
• There is a greater risk of violating the exchangeability assumption of network meta-analysis, especially if broad populations are considered.
• The analysis may be more complex, time- and resource-intensive, and less understood than network meta-analysis that only includes randomized controlled trials.