Systematic review reveals heterogeneity in definition of a clinically relevant difference in pain.

Abstract:

OBJECTIVE:To describe the pain decrease considered as clinically relevant when designing a trial and reporting its results. METHODS:A systematic review of the literature in MEDLINE was conducted to select randomized controlled trials (RCTs) with pain as a primary outcome. Data extracted included the definition (terms and values) of a clinically relevant difference in pain, the type of pain studied (acute or chronic), the level of application (group or individual) of the clinically relevant difference, and the reference justifying the choice of value for clinically relevant difference. STUDY DESIGN AND SETTING:Seventy-four trials were included, and only 16 articles justified the choice of a value for clinically relevant difference with a reference citation. The values chosen for the clinically relevant relative decrease in pain varied from 4 to 40 mm or from 15% to 55% at the group level and from 20 to 50 mm at the individual level. In seven articles, the authors confused the application of the reference value at the individual or group level. CONCLUSION:Our review revealed a great heterogeneity in definition, format, and values of what is considered a clinically relevant difference in pain in RCTs of analgesics, and standardizations are advisable.

journal_name

J Clin Epidemiol

authors

Ruyssen-Witrand A,Tubach F,Ravaud P

doi

10.1016/j.jclinepi.2010.06.008

subject

Has Abstract

pub_date

2011-05-01 00:00:00

pages

463-70

issue

5

eissn

0895-4356

issn

1878-5921

pii

S0895-4356(10)00259-3

journal_volume

64

pub_type

杂志文章,评审
  • Rasch analysis of the PedsQL: an increased understanding of the properties of a rating scale.

    abstract:OBJECTIVE:Traditionally, measures have been developed using classical test theory (CTT). This study examines the psychometrics of the PedsQL 4.0 Generic Core Scales (parent report) using a modern psychometric approach (i.e., Rasch analysis) to determine if further insight regarding the behavior of the measure can be ga...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jclinepi.2012.04.014

    authors: Amin L,Rosenbaum P,Barr R,Sung L,Klaassen RJ,Dix DB,Klassen A

    更新日期:2012-10-01 00:00:00

  • Initial nonresponders had an increased response rate after repeated questionnaire mailings.

    abstract:BACKGROUND AND OBJECTIVE:There is a growing evidence base on methods to improve response rates in surveys among patients. This study aimed to determine the additional effect of two intensive follow-up procedures compared to a simple follow-up procedure. METHODS:Randomized controlled trial that compared repeated mailin...

    journal_title:Journal of clinical epidemiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/j.jclinepi.2005.03.002

    authors: Wensing M,Schattenberg G

    更新日期:2005-09-01 00:00:00

  • FOOTSTEP: a randomized controlled trial investigating the clinical and cost effectiveness of a patient self-management program for basic foot care in the elderly.

    abstract:BACKGROUND AND OBJECTIVES:Podiatry (chiropody) services are one of the most frequently requested services in primary care. The elderly are given priority access to podiatry services in the UK blocking access for other priority groups. To evaluate the clinical and cost-effectiveness of a self-management program as a mea...

    journal_title:Journal of clinical epidemiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0895-4356(03)00197-5

    authors: Waxman R,Woodburn H,Powell M,Woodburn J,Blackburn S,Helliwell P

    更新日期:2003-11-01 00:00:00

  • Community controls were preferred to hospital controls in a case-control study where the cases are derived from the hospital.

    abstract:OBJECTIVE:Cases and controls should be chosen from the same base population to reduce selection bias in case-control studies. For hospital cases, we examined how inferences drawn from a case-control study can differ by choice of hospital- vs. community-based controls. STUDY DESIGN AND SETTINGS:We used data from a case...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/j.jclinepi.2009.11.006

    authors: Neupane B,Walter SD,Krueger P,Loeb M

    更新日期:2010-08-01 00:00:00

  • The statistical significance of meta-analyses is frequently fragile: definition of a fragility index for meta-analyses.

    abstract:OBJECTIVES:Meta-analyses inform clinical practice by summarizing treatment effect estimates based on results from several trials. However, the statistical significance of a meta-analysis (i.e., whether the pooled treatment effect is statistically significant or not) may rely on the outcome of only a few patients from s...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/j.jclinepi.2019.03.012

    authors: Atal I,Porcher R,Boutron I,Ravaud P

    更新日期:2019-07-01 00:00:00

  • Clinical practice guidelines were adapted and implemented meeting country-specific requirements--the example of Kazakhstan.

    abstract:OBJECTIVES:In a twinning partnership between the Canadian Society for International Health and Kazakhstan's Ministry of Health, a project to build capacity and a process for the adaptation and implementation of international clinical practice guidelines (CPGs) was undertaken. STUDY DESIGN AND SETTING:A pragmatic CPG a...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/j.jclinepi.2015.05.001

    authors: McGowan J,Muratov S,Tsepke A,Issina A,Slawecki E,Lang ES

    更新日期:2016-01-01 00:00:00

  • Analysis of non-response bias in a mailed health survey.

    abstract::The objective of this study was to identify characteristics of non-respondents and late respondents to a mailed health survey. Persons who returned and those who did not return the questionnaire were compared using health insurance data, which indicated their age, sex, and health care expenditures in the previous year...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/s0895-4356(97)00166-2

    authors: Etter JF,Perneger TV

    更新日期:1997-10-01 00:00:00

  • Administrative data measured surgical site infection probability within 30 days of surgery in elderly patients.

    abstract:OBJECTIVES:Elderly patients are inordinately affected by surgical site infections (SSIs). This study derived and internally validated a model that used routinely collected health administrative data to measure the probability of SSI in elderly patients within 30 days of surgery. STUDY DESIGN AND SETTING:All people exc...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/j.jclinepi.2016.05.010

    authors: van Walraven C,Jackson TD,Daneman N

    更新日期:2016-09-01 00:00:00

  • Cancer mortality in a residential cohort exposed to environmental selenium through drinking water.

    abstract::Cancer mortality from 1986 to 1992 was examined in a cohort of 4419 individuals who had been residing in an area of the municipality of Reggio Emilia, northern Italy, where tap water with unusually high selenium content was accidentally supplied. Mortality for all cancers was not significantly different, both in males...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(95)00014-u

    authors: Vinceti M,Rovesti S,Gabrielli C,Marchesi C,Bergomi M,Martini M,Vivoli G

    更新日期:1995-09-01 00:00:00

  • Reliability of Bayesian probability analysis for predicting coronary artery disease in a veterans hospital.

    abstract::To assess the accuracy of Bayesian probability analysis for the prediction of coronary artery disease, post-test probabilities were generated by the application of three Bayesian algorithms to the clinical and noninvasive test results of 199 patients undergoing angiography in a veterans' hospital. All assumed conditio...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(88)90065-0

    authors: Detrano R,Guppy KH,Abbassi N,Janosi A,Sandhu S,Froelicher V

    更新日期:1988-01-01 00:00:00

  • Effects on blood pressure of a decrease in sodium use in institutional food preparation: the Exeter-Andover Project.

    abstract::To judge the effect on blood pressure, sodium intake of students at two boarding high schools was reduced by 15-20% through changes in food purchasing and in preparation practices in the schools' kitchens. Students were not asked to change their usual eating habits. Each school served alternately as the control or int...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(89)90056-5

    authors: Ellison RC,Capper AL,Stephenson WP,Goldberg RJ,Hosmer DW Jr,Humphrey KF,Ockene JK,Gamble WJ,Witschi JC,Stare FJ

    更新日期:1989-01-01 00:00:00

  • Methodologists and context experts disagreed regarding managing conflicts of interest of clinical practice guidelines panels.

    abstract:OBJECTIVE:A new strategy to manage conflicts of interests (COIs) of a clinical guideline's panelists gives primary responsibility to a methodologist, puts equal emphasis on intellectual and financial COIs, and excludes panelists with primary conflicts from drafting or voting on recommendations. We explored the views of...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/j.jclinepi.2011.12.013

    authors: Akl EA,Karl R,Guyatt GH

    更新日期:2012-07-01 00:00:00

  • Potentially unnecessary and wasteful clinical trial research detected in cumulative meta-epidemiological and trial sequential analysis.

    abstract:OBJECTIVE:The objective was to estimate the presence and extent to which potentially unnecessary and therefore maybe wasteful clinical trials regarding relevant interventions and outcomes in major clinical areas had been conducted. STUDY DESIGN AND SETTING:From current Cochrane collaboration systematic reviews in majo...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/j.jclinepi.2016.11.003

    authors: Storz-Pfennig P

    更新日期:2017-02-01 00:00:00

  • The impact of changes in coffee consumption on serum cholesterol.

    abstract::To investigate the possible association between changes in coffee consumption and serum cholesterol levels, information was obtained from 2109 healthy nonsmokers aged 25-65 years at two clinic visits to a preventive medical center between 1987 and 1991 (mean interval between visits: 16.7 months). After adjusting for a...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(95)00023-w

    authors: Wei M,Macera CA,Hornung CA,Blair SN

    更新日期:1995-10-01 00:00:00

  • Laboratory data predicts survival post hospitalization.

    abstract::From a database of 93,077 in-patient admissions, patients assigned to catastrophic, very severe, moderately severe, and average 30-day mortality risk categories (as defined in Medicare Hospital Mortality Information, 1989 release, from the Health Care Financing Administration (HCFA] were selected for study. These admi...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(91)90100-n

    authors: Sheiner LB,Easterling MJ,Mozes B,Brown A

    更新日期:1991-01-01 00:00:00

  • Mortality, hospital discharges, and case fatality for pulmonary embolism in the Twin Cities: 1980-1995.

    abstract::Pulmonary embolism (PE) causes substantial morbidity and mortality, but little information is available regarding recent secular trends for PE. This study determined trends for PE in adults ages 30 to 84 years in the Minneapolis-St. Paul metropolitan area from 1980 to 1995. The age-adjusted mortality rate for PE decre...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/s0895-4356(99)00147-x

    authors: Janke RM,McGovern PG,Folsom AR

    更新日期:2000-01-01 00:00:00

  • Are public library books contaminated by bacteria?

    abstract::The microbial flora on the surfaces of 15 books obtained from a public library and from 15 books obtained from a family household were studied. Staphylococcus epidermidis was recovered from 4 of the library books and 3 of the family household books. The number of organisms per page was between one to four. This data i...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(94)90103-1

    authors: Brook SJ,Brook I

    更新日期:1994-10-01 00:00:00

  • Colorectal cancer deaths as determined by expert committee and from death certificate: a comparison. The Minnesota Study.

    abstract::For deaths during the first 13 years of follow-up of the Minnesota Colon Cancer Control Study, an expert committee using numerous medical documents, and a nosologist using only the death certificate independently determined whether colorectal cancer caused the death and, if not, whether the disease was present at deat...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/s0895-4356(99)00016-5

    authors: Ederer F,Geisser MS,Mongin SJ,Church TR,Mandel JS

    更新日期:1999-05-01 00:00:00

  • The Chinese version of the Tampa Scale for Kinesiophobia was cross-culturally adapted and validated in patients with low back pain.

    abstract:OBJECTIVES:The aim of the present study was to obtain a cross-cultural adaptation and evaluation of a Simplified Chinese (SC) version of the Tampa Scale for Kinesiophobia (TSK) for use in patients with low back pain (LBP). STUDY DESIGN AND SETTING:The TSK was translated and adapted cross-culturally following internati...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/j.jclinepi.2015.07.003

    authors: Wei X,Xu X,Zhao Y,Hu W,Bai Y,Li M

    更新日期:2015-10-01 00:00:00

  • Dyslipidemia and abdominal obesity: an assessment in three general populations.

    abstract::Several studies show a relationship between abdominal obesity and cardiovascular diseases, partially mediated through an altered metabolism of dyslipidemia. The present study was aimed at testing the robustness of this association across three contrasted populations and at assessing the performances of abdominal obesi...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/s0895-4356(99)00184-5

    authors: Paccaud F,Schlüter-Fasmeyer V,Wietlisbach V,Bovet P

    更新日期:2000-04-01 00:00:00

  • Mixed-methods research revealed the need for dementia services and Human Resource Master Plan in an aging Philippines.

    abstract:OBJECTIVE:To determine the status of dementia care services and workforce in selected public and private hospitals and geriatric care facilities in the Philippines. STUDY DESIGN AND SETTING:Framework analysis of 54 key informant interviews, 4 focus group discussions, and survey of 167 workers in 26 purposively selecte...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审

    doi:10.1016/j.jclinepi.2018.06.010

    authors: Dela Vega SF,Cordero CP,Palapar LA,Garcia AP,Agapito JD

    更新日期:2018-10-01 00:00:00

  • An observational study showed that explaining randomization using gambling-related metaphors and computer-agency descriptions impeded randomized clinical trial recruitment.

    abstract:OBJECTIVES:To explore how the concept of randomization is described by clinicians and understood by patients in randomized controlled trials (RCTs) and how it contributes to patient understanding and recruitment. STUDY DESIGN AND SETTING:Qualitative analysis of 73 audio recordings of recruitment consultations from fiv...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jclinepi.2018.02.018

    authors: Jepson M,Elliott D,Conefrey C,Wade J,Rooshenas L,Wilson C,Beard D,Blazeby JM,Birtle A,Halliday A,Stein R,Donovan JL,CSAW study group.,Chemorad study group.,POUT study group.,ACST-2 study group.,OPTIMA prelim study group.

    更新日期:2018-07-01 00:00:00

  • Abbreviated literature searches were viable alternatives to comprehensive searches: a meta-epidemiological study.

    abstract:OBJECTIVE:To assess the effects of abbreviated literature searches on evidence syntheses conclusions. STUDY DESIGN AND SETTING:We randomly selected 60 Cochrane reviews of clinical interventions and repeated literature searches using 14 abbreviated approaches (combinations of MEDLINE, Embase, CENTRAL with and without s...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,meta分析

    doi:10.1016/j.jclinepi.2018.05.022

    authors: Nussbaumer-Streit B,Klerings I,Wagner G,Heise TL,Dobrescu AI,Armijo-Olivo S,Stratil JM,Persad E,Lhachimi SK,Van Noord MG,Mittermayr T,Zeeb H,Hemkens L,Gartlehner G

    更新日期:2018-10-01 00:00:00

  • Improved self-confidence was a mechanism of action in two geriatric trials evaluating physical interventions.

    abstract:OBJECTIVE:To evaluate the mechanisms of action in two successful geriatric clinical trials that tested multicomponent physical conditioning programs and to determine whether the pathways for overall benefit were through improvement in physical ability and/or self-confidence. STUDY DESIGN AND SETTING:PREHAB and DRIVER ...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.jclinepi.2006.04.009

    authors: Peduzzi P,Guo Z,Marottoli RA,Gill TM,Araujo K,Allore HG

    更新日期:2007-01-01 00:00:00

  • A full competing risk analysis of hospital-acquired infections can easily be performed by a case-cohort approach.

    abstract:OBJECTIVES:We provide a case-cohort approach and show that a full competing risk analysis is feasible even in a reduced data set. Competing events for hospital-acquired infections are death or discharge from the hospital because they preclude the observation of such infections. STUDY DESIGN AND SETTING:Using surveilla...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.jclinepi.2015.11.011

    authors: Wolkewitz M,Palomar-Martinez M,Olaechea-Astigarraga P,Alvarez-Lerma F,Schumacher M

    更新日期:2016-06-01 00:00:00

  • Examination by logistic regression modelling of the variables which increase the relative risk of elderly women falling compared to elderly men.

    abstract::In a community based, prospective study to determine risk factors for falls, 465 women and 296 men 70 years and over were followed for 1 year and 507 falls were documented. A greater proportion of women (32.7%) than men (23.0%) experienced at least one fall in which there was no or minimal external contribution. Using...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(90)90110-b

    authors: Campbell AJ,Spears GF,Borrie MJ

    更新日期:1990-01-01 00:00:00

  • Correspondence analysis is a useful tool to uncover the relationships among categorical variables.

    abstract:OBJECTIVE:Correspondence analysis (CA) is a multivariate graphical technique designed to explore the relationships among categorical variables. Epidemiologists frequently collect data on multiple categorical variables with the goal of examining associations among these variables. Nevertheless, CA appears to be an under...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/j.jclinepi.2009.08.008

    authors: Sourial N,Wolfson C,Zhu B,Quail J,Fletcher J,Karunananthan S,Bandeen-Roche K,Béland F,Bergman H

    更新日期:2010-06-01 00:00:00

  • The effect of local recurrence on survival time in adult high-grade soft tissue sarcomas.

    abstract::Data gathered on 262 adults with high-grade soft tissue sarcoma, operated on at the same institution for curative intent, were used to study formally, and to quantitate for the first time, the relationship between local recurrence of the tumor and survival time. Using Cox's proportional hazards model with a time-depen...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(89)90083-8

    authors: Emrich LJ,Ruka W,Driscoll DL,Karakousis CP

    更新日期:1989-01-01 00:00:00

  • Methodologic considerations in measuring glycosylated hemoglobin in epidemiologic studies.

    abstract::Multiple linear regression was used to predict an incubated glycosylated hemoglobin value from the unincubated value and blood glucose. Hemoglobin A1 (HbA1) was measured by a disposable microcolumn technique in a large, geographically defined population of diabetic persons in southern Wisconsin. During the study, incu...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章

    doi:10.1016/0895-4356(88)90116-3

    authors: Moss SE,Klein R,Klein BE,Spennetta TL,Shrago ES

    更新日期:1988-01-01 00:00:00

  • Linguistic validation and reliability properties are weak investigated of most dementia-specific quality of life measurements-a systematic review.

    abstract:OBJECTIVE:For people with dementia, the concept of quality of life (Qol) reflects the disease's impact on the whole person. Thus, Qol is an increasingly used outcome measure in dementia research. This systematic review was performed to identify available dementia-specific Qol measurements and to assess the quality of l...

    journal_title:Journal of clinical epidemiology

    pub_type: 杂志文章,评审

    doi:10.1016/j.jclinepi.2015.08.002

    authors: Dichter MN,Schwab CG,Meyer G,Bartholomeyczik S,Halek M

    更新日期:2016-02-01 00:00:00