Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials
Introduction Chronic, non-cancer, axial or radicular spinal pain is a common condition associated with considerable socioeconomic burden. Clinicians frequently offer patients various interventional procedures for the treatment of chronic spine pain; however, the comparative effectiveness and safety...
Main Authors: | , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMJ Publishing Group
2021-07-01
|
Series: | BMJ Open |
Online Access: | https://bmjopen.bmj.com/content/11/7/e046025.full |
id |
doaj-8032e71a165f4437b7afd70a754bef28 |
---|---|
record_format |
Article |
spelling |
doaj-8032e71a165f4437b7afd70a754bef282021-10-11T10:00:05ZengBMJ Publishing GroupBMJ Open2044-60552021-07-0111710.1136/bmjopen-2020-046025Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trialsXiaoqin Wang0Behnam Sadeghirad1Ivan D Florez2Yaping Chang3Y Raja Rampersaud4Grace Martin5Holly N Crandon6Meisam Abdar Esfahani7Laxsanaa Sivananthan8Fatemeh Mehrabi9Neil K Sengupta10Preksha Rathod11Rami Z Morsi12Christopher J Standaert13Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, CanadaMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, CanadaDepartment of Pediatrics, Universidad de Antioquia, Medellin, ColombiaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, CanadaArthritis Program, Krembil Research Institute, Division of Orthopaedics, University Health Network, Toronto, Ontario, CanadaMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, CanadaFaculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, CanadaGraduate Entry Medical School, University of Limerick, Limerick, IrelandPharmaceutic Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, IranMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, CanadaMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, CanadaDepartment of Neurology, University of Chicago, Chicago, Illinois, USADepartment of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USAIntroduction Chronic, non-cancer, axial or radicular spinal pain is a common condition associated with considerable socioeconomic burden. Clinicians frequently offer patients various interventional procedures for the treatment of chronic spine pain; however, the comparative effectiveness and safety of available procedures remains uncertain.Methods We will conduct a systematic review of randomised controlled trials that explores the effectiveness and harms of interventional procedures for the management of axial or radicular, chronic, non-cancer, spine pain. We will identify eligible studies through a systematic search of Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science from inception without language restrictions. Eligible trials will: (1) enrol primarily adult patients (≥18 years old) with axial or radicular, chronic, non-cancer, spine pain, (2) randomise patients to different, currently available, interventional procedures or to an interventional procedure and a placebo/sham procedure or usual care, and (3) measure outcomes at least 1 month after randomisation.Pairs of reviewers will independently screen articles identified through searches and extract information and assess risk of bias of eligible trials. We will use a modified Cochrane instrument to evaluate risk of bias. We will use frequentist random-effects network meta-analyses to assess the relative effects of interventional procedures, and five a priori hypotheses to explore between studies subgroup effects. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in evidence for each outcome, including direct, indirect and network estimates.Ethics and dissemination No research ethics approval is required for this systematic review, as no confidential patient data will be used. We will disseminate our findings through publication in a peer-reviewed journal and conference presentations, and our review will support development of a BMJ Rapid Recommendations providing contextualised clinical guidance based on this body of evidence.PROSPERO registration number CRD42020170667.https://bmjopen.bmj.com/content/11/7/e046025.full |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xiaoqin Wang Behnam Sadeghirad Ivan D Florez Yaping Chang Y Raja Rampersaud Grace Martin Holly N Crandon Meisam Abdar Esfahani Laxsanaa Sivananthan Fatemeh Mehrabi Neil K Sengupta Preksha Rathod Rami Z Morsi Christopher J Standaert |
spellingShingle |
Xiaoqin Wang Behnam Sadeghirad Ivan D Florez Yaping Chang Y Raja Rampersaud Grace Martin Holly N Crandon Meisam Abdar Esfahani Laxsanaa Sivananthan Fatemeh Mehrabi Neil K Sengupta Preksha Rathod Rami Z Morsi Christopher J Standaert Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials BMJ Open |
author_facet |
Xiaoqin Wang Behnam Sadeghirad Ivan D Florez Yaping Chang Y Raja Rampersaud Grace Martin Holly N Crandon Meisam Abdar Esfahani Laxsanaa Sivananthan Fatemeh Mehrabi Neil K Sengupta Preksha Rathod Rami Z Morsi Christopher J Standaert |
author_sort |
Xiaoqin Wang |
title |
Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials |
title_short |
Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials |
title_full |
Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials |
title_fullStr |
Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials |
title_full_unstemmed |
Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials |
title_sort |
interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials |
publisher |
BMJ Publishing Group |
series |
BMJ Open |
issn |
2044-6055 |
publishDate |
2021-07-01 |
description |
Introduction Chronic, non-cancer, axial or radicular spinal pain is a common condition associated with considerable socioeconomic burden. Clinicians frequently offer patients various interventional procedures for the treatment of chronic spine pain; however, the comparative effectiveness and safety of available procedures remains uncertain.Methods We will conduct a systematic review of randomised controlled trials that explores the effectiveness and harms of interventional procedures for the management of axial or radicular, chronic, non-cancer, spine pain. We will identify eligible studies through a systematic search of Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science from inception without language restrictions. Eligible trials will: (1) enrol primarily adult patients (≥18 years old) with axial or radicular, chronic, non-cancer, spine pain, (2) randomise patients to different, currently available, interventional procedures or to an interventional procedure and a placebo/sham procedure or usual care, and (3) measure outcomes at least 1 month after randomisation.Pairs of reviewers will independently screen articles identified through searches and extract information and assess risk of bias of eligible trials. We will use a modified Cochrane instrument to evaluate risk of bias. We will use frequentist random-effects network meta-analyses to assess the relative effects of interventional procedures, and five a priori hypotheses to explore between studies subgroup effects. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in evidence for each outcome, including direct, indirect and network estimates.Ethics and dissemination No research ethics approval is required for this systematic review, as no confidential patient data will be used. We will disseminate our findings through publication in a peer-reviewed journal and conference presentations, and our review will support development of a BMJ Rapid Recommendations providing contextualised clinical guidance based on this body of evidence.PROSPERO registration number CRD42020170667. |
url |
https://bmjopen.bmj.com/content/11/7/e046025.full |
work_keys_str_mv |
AT xiaoqinwang interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT behnamsadeghirad interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT ivandflorez interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT yapingchang interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT yrajarampersaud interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT gracemartin interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT hollyncrandon interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT meisamabdaresfahani interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT laxsanaasivananthan interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT fatemehmehrabi interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT neilksengupta interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT preksharathod interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT ramizmorsi interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials AT christopherjstandaert interventionaltreatmentsforchronicaxialorradicularnoncancerspinalpainaprotocolforasystematicreviewandnetworkmetaanalysisofrandomisedtrials |
_version_ |
1716827874670936064 |