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MDR\u2010TB is always treated with multiple antimicrobial agents. Our data consist of individual patient data from 31 international observational studies with varying prescription practices, access to medications, and distributions of antibiotic resistance. In this study, we develop identifiability criteria for the estimation of a global treatment importance metric in the context where not all medications are observed in all studies. With stronger causal assumptions, this treatment importance metric can be interpreted as the effect of adding a medication to the existing treatments. We then use this metric to rank 15 observed antimicrobial agents in terms of their estimated add\u2010on value. Using the concept of transportability, we propose an implementation of targeted maximum likelihood estimation, a doubly robust and locally efficient plug\u2010in estimator, to estimate the treatment importance metric. A clustered sandwich estimator is adopted to compute variance estimates and produce confidence intervals. Simulation studies are conducted to assess the performance of our estimator, verify the double robustness property, and assess the appropriateness of the variance estimation\u00a0approach.<\/jats:p>","DOI":"10.1111\/biom.13210","type":"journal-article","created":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T14:52:15Z","timestamp":1577112735000},"page":"1007-1016","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Estimating treatment importance in multidrug\u2010resistant tuberculosis using Targeted Learning: An observational individual patient data network meta\u2010analysis"],"prefix":"10.1093","volume":"76","author":[{"given":"Guanbo","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Epidemiology Biostatistics and Occupational Health McGill University Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mireille E.","family":"Schnitzer","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy Universit\u00e9 de Montr\u00e9al Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Department of Social and Preventive Medicine Universit\u00e9 de Montr\u00e9al Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dick","family":"Menzies","sequence":"additional","affiliation":[{"name":"Respiratory Epidemiology and Clinical Research Unit McGill University Health Centre Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Department of Medicine McGill University Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piret","family":"Viiklepp","sequence":"additional","affiliation":[{"name":"Estonian Tuberculosis Registry National Institute for Health Development Tallinn Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy H.","family":"Holtz","sequence":"additional","affiliation":[{"name":"Division of Global HIV and TB Centers for Disease Control and Prevention Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Benedetti","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Biostatistics and Occupational Health McGill University Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Respiratory Epidemiology and Clinical Research Unit McGill University Health Centre Montr\u00e9al Qu\u00e9bec Canada"},{"name":"Department of Medicine McGill University Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,1,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001300"},{"key":"e_1_2_8_3_1","unstructured":"Ak\u00e7ak\u0131r Y.(2009)Correlates of treatment outcomes of multidrug\u2010resistant tuberculosis (MDR\u2010TB): a systematic review and meta\u2010analysis. 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