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IMMPACT领域在慢性疼痛针灸临床试验中的应用:一项方法学调查方案

Use of IMMPACT domains in clinical trials of acupuncture for chronic pain: a protocol for a methodological survey.

作者信息

Mazzei Lauren Giustti, Bergamaschi Cristiane de Cássia, Silva Marcus Tolentino, Lopes Luciane Cruz

机构信息

Department of Pharmaceutical Sciences Graduate Program, University of Sorocaba, Sorocaba, São Paulo, Brazil.

出版信息

BMJ Open. 2017 Sep 27;7(9):e014904. doi: 10.1136/bmjopen-2016-014904.

Abstract

INTRODUCTION

Pain is one of the most common and most debilitating complaints among patients. It affects the individual, their relationship with friends and family, their ability to function at work, and their sociability. Acupuncture is one of the therapeutic resources for managing chronic pain. Given the variability of outcome measures in controlled randomised clinical trials on non-oncologicchronic pain (CRCT-NOCP), the Initiative in Methods, Measurements and Pain Assessment in Clinical Trials (IMMPACT) recommends six domains to be covered in evaluating the effectiveness of treatments for chronic pain.

OBJECTIVE

To check whether the methodological quality of outcome reporting in published trials has used IMMPACT recommendations in measuring CRCT-NOCP outcomes when acupuncture was used as a treatment.

METHOD

This is a methodological study. We will systematically search for eligible studies in specific databases with a defined strategy. We will use the MeSHterms of 'acupuncture', 'chronic pain' and similar terms, without restrictions on idiom. Eligible studies will include those which are randomised and chose NOCP patients to be treated with acupuncture or control (sham acupuncture or no acupuncture), recruited after September 2004, with ≥100 patients. The measured outcomes are to be the presence of outcome domains recommended by IMMPACT, domains reported by the patient or clinician, tools used to measure such domains, as well as other features of the studies. We shall conduct a regression analysis to explore factors which can be associated with the presence of outcome domains according to IMMPACT recommendations.

ETHICS AND DISSEMINATION

This survey will be submitted for presentation at congresses and for publication in a scientific journal. The findings obtained in this study will allow us to measure the quality of the evidence and provide greater transparency in decisions regarding the use of acupuncture as a viable alternative to managing chronic pain.

摘要

引言

疼痛是患者中最常见且最使人衰弱的主诉之一。它会影响个体、其与朋友和家人的关系、工作能力以及社交能力。针灸是管理慢性疼痛的治疗手段之一。鉴于非肿瘤性慢性疼痛对照随机临床试验(CRCT - NOCP)中结局测量的变异性,临床试验方法、测量与疼痛评估倡议组织(IMMPACT)建议在评估慢性疼痛治疗效果时涵盖六个领域。

目的

检查已发表试验中结局报告的方法学质量在将针灸用作治疗手段测量CRCT - NOCP结局时是否采用了IMMPACT建议。

方法

这是一项方法学研究。我们将采用既定策略在特定数据库中系统检索符合条件的研究。我们将使用“针灸”“慢性疼痛”等医学主题词(MeSH)以及类似术语,不限制语言。符合条件的研究将包括那些随机分组且选择非肿瘤性慢性疼痛患者接受针灸或对照(假针灸或不针灸)治疗的研究(2004年9月之后招募,患者≥100例)。测量的结局应为IMMPACT建议的结局领域的存在情况、患者或临床医生报告的领域、用于测量此类领域的工具以及研究的其他特征。我们将进行回归分析,以探索根据IMMPACT建议可能与结局领域存在情况相关的因素。

伦理与传播

本次调查将提交至各大会进行展示,并发表在科学期刊上。本研究获得的结果将使我们能够衡量证据质量,并在关于使用针灸作为管理慢性疼痛可行替代方法的决策中提供更高的透明度。

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