Evidence map›Paper›PMID 16869819›Full record

SynthesisBritish journal of clinical pharmacology2007

Dose-response in direct comparisons of different doses of aspirin, ibuprofen and paracetamol (acetaminophen) in analgesic studies.

Henry J McQuay, R Andrew Moore

Registry-linked trialAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in British journal of clinical pharmacology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04779567 (Randomized Double-blind Controlled Study to Assess the Efficacy of Intravenous Acetaminophen Associated With Strong Opioids in the Management of Acute Pain in Adult Cancer Patients), which is not on this map. Cited by 34 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 12 pooled it
–field-weighted citation impact
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.

NCT04779567 phase4completednot on this mapstarted 2019, after this paper: background citation

Randomized Double-blind Controlled Study to Assess the Efficacy of Intravenous Acetaminophen Associated With Strong Opioids in the Management of Acute Pain in Adult Cancer Patients

TypeinterventionalSponsorPontificia Universidad Catolica de ChileRan2019 to 2021Enrolled112ConditionsAcute Pain, Cancer PainArmsAcetaminophen, Placebo
3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 12 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Oral paracetamol (acetaminophen) for cancer pain.The Cochrane database of systematic reviews · 2017
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Caffeine as an analgesic adjuvant for acute pain in adults.The Cochrane database of systematic reviews · 2014
    Pooled it
  8. Single dose oral aspirin for acute postoperative pain in adults.The Cochrane database of systematic reviews · 2012
    Pooled it
  9. Pooled it
  10. Pooled it
  11. Single dose oral ibuprofen for acute postoperative pain in adults.The Cochrane database of systematic reviews · 2009
    Pooled it
  12. Pooled it
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Article
  18. The Effect of Hydroalcoholic Extract ofFood science & nutrition · 2025
    Article
  19. The 125th Anniversary of Aspirin-The Story Continues.Pharmaceuticals (Basel, Switzerland) · 2024
    Review
  20. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Henry J McQuayPain Research and Nuffield Department of Anaesthetics, (University of Oxford), Churchill Hospital, Oxford, UK. henry.mcquay@pru.ox.ac.uk
R Andrew Moore

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsEstablishing the dose-response relationship for clinically useful doses of aspirin, ibuprofen and paracetamol has been difficult. Indirect comparison from meta-analysis is compromised by too little information at some doses.

methodsA systematic review of randomized, double-blind trials in acute pain comparing different doses of aspirin, ibuprofen and paracetamol was therefore undertaken.

resultsFifty trials were found. Numerical superiority of higher over lower dose was found by the original authors in 37/50 trials (74%) and statistical superiority in 11/50 (22%). Twenty-eight trials had design, quality and data reporting characteristics to allow pooling of common doses; in 3/28 (11%) of the individual trials our calculations showed statistical superiority of higher over lower dose. Pooled comparison of 1000/1200 mg aspirin over 500/600 mg was statistically superior, with a number-needed-to-treat (NNT) for higher over lower dose of 16 (8 to > 100). Pooled comparison of 400 mg ibuprofen over 200 mg was statistically superior, with an NNT for higher over lower dose of 10 (6-23). Pooled comparison of 1000 mg paracetamol over 500 mg was statistically superior, with an NNT for higher over lower dose of 9 (6-20).

conclusionsUse of trials making direct comparison of two different doses of target drugs revealed the underlying dose-response curve for clinical analgesia.

Indexed as

Dose-Response Relationship, DrugAcetaminophenAnalgesicsAspirinDouble-Blind MethodHumansIbuprofenPain MeasurementRandomized Controlled Trials as TopicAcetaminophenAnalgesicsAspirinIbuprofen

Identifiers

PMID16869819
PMCPMC2000740

What OpenQuestion holds

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Registered trials

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.