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...

Full description

Bibliographic Details
Main Authors: 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
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