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A simulated treatment comparison is a method for comparing interventions across trials without head-to-head evidence, in which individual patient data from one trial are used to fit a model relating patient characteristics to outcome, and that model is then used to predict outcomes in the population of a comparator trial. By adjusting for differences in the distribution of prognostic characteristics between the trials, it aims to reduce the bias that can affect a naive indirect comparison, in a manner related to the matching-adjusted indirect comparison. Its validity depends on the availability of patient-level data, on correctly specifying the outcome model, and on the comparability of the trials in unmeasured respects. Because it relies on these assumptions, its results should be reported transparently and tested through sensitivity analysis.

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