Evidence map›Paper›PMID 11231885›Full record

ReviewBMC medical research methodology2001

Using evidence from different sources: an example using paracetamol 1000 mg plus codeine 60 mg.

L A Smith, R A Moore, H J McQuay, D Gavaghan

Open access · goldAbstract readReview
In one paragraph

Review in BMC medical research methodology, 2001. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.

  1. Single dose oral lumiracoxib for postoperative pain.The Cochrane database of systematic reviews · 2007
    Pooled it
  2. Tighter regulations needed for over-the-counter codeine in Canada.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

L A SmithPain Research & Nuffield Department of Anaesthetics, University of Oxford, Oxford, UK. lesley.smith@pru.ox.ac.uk
R A Moore
H J McQuay
D Gavaghan
University of Oxford · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMeta-analysis usually restricts the information pooled, for instance using only randomised, double-blind, placebo-controlled trials. This neglects other types of high quality information. This review explores using different information for the combination of paracetamol 1000 mg and codeine 60 mg in acute postoperative pain.

resultsRandomised, double-blind, placebo-controlled trials of paracetamol 1000 mg and codeine 60 mg had an NNT of 2.2 (95% confidence interval 1.7 to 2.9) for at least 50% pain relief over four to six hours in three trials with 197 patients. Computer simulation of randomised trials demonstrated 92% confidence that the simulated NNT was within +/- 0.5 of the underlying value of 2.2 with this number of patients. The result was supported a rational dose-response relationship for different doses of paracetamol and codeine in 17 additional trials with 1,195 patients. Three controlled trials lacking a placebo and with 117 patients treated with of paracetamol 1000 mg and codeine 60 mg had 73% (95%CI 56% to 81%) of patients with at least 50% pain relief, compared with 57% (48% to 66%) in placebo controlled trials. Six trials in acute pain were omitted because of design issues, like the use of different pain measures or multiple dosing regimens. In each paracetamol 1000 mg and codeine 60 mg was shown to be better than placebo or comparators for at least one measure.

conclusionsDifferent designs of high quality trials can be used to support limited information used in meta-analysis without recourse to low quality trials that might be biased.

Indexed as

Meta-Analysis as TopicAcetaminophenAnalgesics, Non-NarcoticAnalgesics, OpioidAspirinCodeineDrug CombinationsDrug Therapy, CombinationHumansPostoperative PainQuality ControlRandomized Controlled Trials as TopicTreatment OutcomeAcetaminophenAnalgesics, Non-NarcoticAnalgesics, OpioidAspirinaspirin, codeine drug combinationCodeineDrug Combinations

Identifiers

PMID11231885
PMCPMC32200
OpenAlexW1924591211

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.