Evidence map›Paper›PMID 27007463›Full record

ArticleCognitive behaviour therapy2016

Exposure-based Interventions for the management of individuals with high levels of needle fear across the lifespan: a clinical practice guideline and call for further research.

C Meghan McMurtry, Anna Taddio, Melanie Noel, Martin M Antony, Christine T Chambers, Gordon J G Asmundson, Rebecca Pillai Riddell, Vibhuti Shah, Noni E MacDonald, Jess Rogers and 15 more

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In one paragraph

Article in Cognitive behaviour therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 3 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.

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

42 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Reducing distress during vaccine injections: 2026 clinical practice guideline update.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026
    Guideline
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  16. EANM procedural recommendations for managing the paediatric patient in diagnostic nuclear medicine.European journal of nuclear medicine and molecular imaging · 2023
    Review
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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

25 authors.

C Meghan McMurtrya Department of Psychology , University of Guelph , Guelph , Canada.
Anna Taddioe Leslie Dan Faculty of Pharmacy , University of Toronto , Toronto , Canada.
Melanie Noelg Department of Psychology , University of Calgary , Calgary , Canada.
Martin M Antonyi Department of Psychology , Ryerson University , Toronto , Canada.
Christine T Chambersj Department of Pediatrics, Department of Psychology and Neuroscience , Dalhousie University , Halifax , Canada.
Gordon J G Asmundsonl Department of Psychology, Faculty of Arts , University of Regina , Regina , Canada.
Rebecca Pillai Riddellf The Hospital for Sick Children , Toronto , Canada.
Vibhuti Shaho Mount Sinai Hospital , Toronto , Canada.
Noni E MacDonaldq Department of Pediatrics , Dalhousie University , Halifax , Canada.
Jess Rogersu Centre for Effective Practice , Toronto , Canada.
Lucie M Bucciw Immunize Canada , Ottawa , Canada.
Patricia Mousmanisy College of Family Physicians of Canada , Toronto , Canada.
Eddy Langz Alberta Health Services and the Cumming School of Medicine , University of Calgary , Calgary , Canada.
Scott Halperinq Department of Pediatrics , Dalhousie University , Halifax , Canada.
Susan Bowlesaa College of Pharmacy , Dalhousie University , Halifax , Canada.
Christine Halpertab Immunization Programs and Vaccine Preventable Diseases Service , BC Centre for Disease Control , Vancouver , Canada.
Moshe Ippf The Hospital for Sick Children , Toronto , Canada.
Michael J Riederad Departments of Paediatrics, Physiology & Pharmacology and Medicine, Schulich School of Medicine & Dentistry , Western University , London , Canada.
Kate Robsonae Canadian Family Advisory Network , Toronto , Canada.
Elizabeth Ulerykaf Uleryk Consulting , Toronto , Canada.
Elizabeth Votta Bleekerag Science Directorate, Canadian Psychological Association , Ottawa , Canada.
Vinita Dubeyah Toronto Public Health , Toronto , Canada.
Anita Hanrahanai Communicable Disease Control, Alberta Health Services , Edmonton , Canada.
Donna Lockettaj Bodhi Seed Center for Healing and Conscious Living , Milton , Canada.
Jeffrey Scottak Department of Emergency Medicine , IWK Health Centre , Halifax , Canada.

Funding

Canadian Institutes of Health Research 132031
6 · The paper itself

Abstract

Needle fear typically begins in childhood and represents an important health-related issue across the lifespan. Individuals who are highly fearful of needles frequently avoid health care. Although guidance exists for managing needle pain and fear during procedures, the most highly fearful may refuse or abstain from such procedures. The purpose of a clinical practice guideline (CPG) is to provide actionable instruction on the management of a particular health concern; this guidance emerges from a systematic process. Using evidence from a rigorous systematic review interpreted by an expert panel, this CPG provides recommendations on exposure-based interventions for high levels of needle fear in children and adults. The AGREE-II, GRADE, and Cochrane methodologies were used. Exposure-based interventions were included. The included evidence was very low quality on average. Strong recommendations include the following. In vivo (live/in person) exposure-based therapy is recommended (vs. no treatment) for children seven years and older and adults with high levels of needle fear. Non-in vivo (imaginal, computer-based) exposure (vs. no treatment) is recommended for individuals (over seven years of age) who are unwilling to undergo in vivo exposure. Although there were no included trials which examined children < 7 years, exposure-based interventions are discussed as good clinical practice. Implementation considerations are discussed and clinical tools are provided. Utilization of these recommended practices may lead to improved health outcomes due to better health care compliance. Research on the understanding and treatment of high levels of needle fear is urgently needed; specific recommendations are provided.

Indexed as

NeedlesAdultChildFearHumansImplosive TherapyPhobic Disordersblood–injection–injuryclinical practice guidelineexposureFearneedlephobia

Identifiers

PMID27007463
PMCPMC4867871

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.