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Dr Deborah Caldwell

Health Technology Assessment and evidence synthesis of complex health interventions

I am currently funded by an MRC post-doctoral Population Health Scientist fellowship award. My project outline is as follows:

Establishing the most effective treatment(s) for depression is a population health priority. By 2020 depression will be the second highest cause of disease worldwide, with the cost to the NHS around £9 billion. Evidence synthesis using randomised controlled trials (RCTs) underpins Health Technology Assessment (HTA) and clinical guidelines. However, empirical evidence suggests psychiatric RCTs are susceptible to bias, raising questions about reliability and validity of effect estimates from psychiatric HTA. Two recent methodological developments make it possible to control for bias in psychiatric HTA; Bias-adjusted meta-analysis and Mixed Treatment Comparisons. 

The aim of the project is to examine the suitability of MTC for psychiatric RCTs and assess how biases in evidence synthesis of psychiatric RCTs can be controlled and mitigated to generate more precise, valid estimates of treatment effect. I will;

1.            explore the benefits of bias-adjusted MTC compared to standard meta-analysis in the presence of quality-related biases and effect modifiers,

2.            assess the effect of extending an MTC network of evidence for depression to include all relevant treatments and assess the ‘risk of bias’ for each included RCT;

3.            explore and compare the effects of bias adjustment on treatment effects estimates in the extended depression network of evidence, using approaches proposed by Turner, Welton and Dias


Further projects I am involved in include NIHR HTA funded projects:

- "Which method is best for the induction of labour: A systematic review, network meta-analysis and cost-effectiveness analysis" 

- "What is/are the best oral anticoagulant/s for primary prevention, treatment and secondary prevention of venous thromboembolic disease, and for prevention of stroke in atrial fibrillation?.” 

- "A systematic review of the clinical effectiveness and cost-effectiveness of pharmacological and psychological interventions for the management of obsessive-compulsive disorder in children/adolescents and adults"

An MRC methodology project

- "Developing ROBIS - a new tool to assess the risk of bias in systematic reviews".

And along with colleagues in the Cochrane Comparing Multiple Interventions method group, I am examining methods for comparing multiple interventions in Cochrane Intervention reviews and Overviews of reviews.

Research keywords

  • Network Meta-Analysis
  • Evidence Synthesis
  • Health Technology Assessment
  • Cochrane Collaboration
  • Mental Health.

Diseases related to this field of research

  • Mental health
  • depression
  • panic disorder
  • OCD
  • obstetrics and gynaecology