Comments on Biologic Ranking Methodology Used by the Network Meta-Analysis to Inform the 2024 Ulcerative Colitis Guideline
The American Gastroenterology Association (AGA) with Ananthakrishnan et al1 has published online in Gastroenterology the evidence synthesis of their frequentist network meta-analysis (NMA) comparing the efficacy of advanced therapies for the management of moderate-to-severe ulcerative colitis (UC) to inform the living AGA UC guidelines. Although the methodology used for this NMA (Grading of Recommendations Assessment, Development and Evaluation [GRADE]), is commonly used to appraise certainty of evidence, the statistical methodology used in this GRADE application has several limitations that make it inappropriate for this purpose.
