Poor Reporting and Methodological Quality of Network Meta-Analyses in Gastroenterology: Protocol for a Meta-Epidemiological Study

Background Network meta-analysis (NMA) has become increasingly influential in evidence synthesis and clinical guideline development. The number of published NMAs has grown rapidly in recent years, including within gastroenterology and hepatology. To date, no comprehensive evaluation has specifically assessed the methodological and reporting quality of NMAs in gastroenterology. This study aims to evaluate key methodological characteristics and reporting practices of recently published NMAs in this field. Methods We will conduct a cross-sectional meta-epidemiological study of NMAs published in gastroenterology and hepatology. Electronic searches will be performed in MEDLINE, Embase, and the Cochrane Database of Systematic Reviews to identify eligible studies published between January and October 2025. Two independent reviewers will screen studies and extract data using a predefined form. Included studies will be NMAs evaluating any pharmacological, screening, preventive, behavioural, or technological interventions in gastroenterology or hepatology populations. Studies focusing exclusively on cancer, transplantation, or purely surgical interventions will be excluded. Extracted data will include general study characteristics, methodological approaches, reporting standards, protocol availability, risk of bias assessment tools, and certainty of evidence frameworks such as GRADE or CINeMA. Additional data will be collected on how NMAs report direct, indirect, and network estimates, as well as the use of ranking statistics and summary of findings tables. Results will be summarised using descriptive statistics, including absolute frequencies, percentages, medians, and ranges. McNemar’s test will be used to compare planned methodological approaches with reported analyses.