The article discusses the challenges and methods for comparing multiple treatments in evidence-based decision-making, particularly in the context of acute myocardial infarction. It highlights the limitations of standard meta-analyses, which often focus on direct comparisons between treatments, making it difficult to determine the best treatment option. The authors propose a method that combines both direct and indirect evidence to provide a more comprehensive evaluation of multiple treatments. This approach is illustrated through a case study comparing seven treatments for acute myocardial infarction, showing that it can lead to more precise and reliable conclusions compared to traditional pair-wise meta-analyses. The article also addresses concerns about bias and randomization, emphasizing the importance of expert judgment in interpreting the results. The authors conclude that while these methods are not without assumptions, they offer a valuable tool for integrating and analyzing complex evidence in clinical practice and policy decisions.The article discusses the challenges and methods for comparing multiple treatments in evidence-based decision-making, particularly in the context of acute myocardial infarction. It highlights the limitations of standard meta-analyses, which often focus on direct comparisons between treatments, making it difficult to determine the best treatment option. The authors propose a method that combines both direct and indirect evidence to provide a more comprehensive evaluation of multiple treatments. This approach is illustrated through a case study comparing seven treatments for acute myocardial infarction, showing that it can lead to more precise and reliable conclusions compared to traditional pair-wise meta-analyses. The article also addresses concerns about bias and randomization, emphasizing the importance of expert judgment in interpreting the results. The authors conclude that while these methods are not without assumptions, they offer a valuable tool for integrating and analyzing complex evidence in clinical practice and policy decisions.