Document Detail


Using evidence in pain practice: Part II: Interpreting and applying systematic reviews and clinical practice guidelines.
MedLine Citation:
PMID:  18346061     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Systematic reviews and clinical practice guidelines are useful tools for bringing evidence into pain practice. However, even when their conclusions or recommendations appear valid, interpreting and applying systematic reviews and clinical practice guidelines in everyday practice is not always straightforward. Judging external validity or applicability of findings requires careful consideration of factors related to patient selection, clinical setting, feasibility, costs, and availability of interventions. Clinicians should also consider whether effects on clinically relevant outcomes are large enough to warrant use of the intervention in question. Other challenges to using systematic reviews and clinical practice guidelines in pain practice include the need to make decisions about pain interventions when evidence is weak or inconclusive, and the increasing and confusing presence of discordant systematic reviews and clinical practice guidelines. This article discusses how to evaluate applicability and clinical relevance of systematic reviews and clinical practice guidelines, and provides a framework for approaching clinical decisions when evidence is weak or conflicting.
Authors:
Roger Chou
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Pain medicine (Malden, Mass.)     Volume:  9     ISSN:  1526-4637     ISO Abbreviation:  Pain Med     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-09-05     Completed Date:  2008-11-04     Revised Date:  2009-04-16    
Medline Journal Info:
Nlm Unique ID:  100894201     Medline TA:  Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  531-41     Citation Subset:  IM    
Affiliation:
Oregon Evidence-Based Practice Center, Department of Medicine, Oregon Health and Science University, Portland, Oregon, USA. chour@ohsu.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Clinical Trials as Topic
Decision Making
Evidence-Based Medicine / standards*
Humans
Pain / physiopathology,  therapy*
Practice Guidelines as Topic / standards*
Review Literature as Topic*
Comments/Corrections
Comment In:
Pain Med. 2009 Mar;10(2):422-4; author reply 425-7   [PMID:  19254340 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Pregabalin in the treatment of refractory neuropathic pain: results of a 15-month open-label trial.
Next Document:  Using evidence in pain practice: Part I: Assessing quality of systematic reviews and clinical practi...