Evidence map›Paper›PMID 27288381›Full record

Trial reportBMJ open2016

SWIM (sickle with ibuprofen and morphine) randomised controlled trial fails to recruit: lessons learnt.

Gavin Cho, Kofi A Anie, Jacky Buckton, Patricia Kiilu, Mark Layton, Lydia Alexander, Claire Hemmaway, Dorothy Sutton, Claire Amos, Caroline J Doré and 2 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00880373 (An Evaluation of the Effectiveness of Ibuprofen and Opioid), which is not on this map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 41% 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.

NCT00880373 phase4terminatednot on this map

An Evaluation of the Effectiveness of Ibuprofen and Opioid (Morphine or Diamorphine) for Acute Pain in Sickle Cell Disease: a Double-blind, Placebo-controlled Randomised Trial

TypeinterventionalSponsorLondon North West Healthcare NHS TrustRan2011 to 2014Enrolled320ConditionsSickle Cell DiseaseArmsIbuprofen, Placebo, Diamorphine or Morphine
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. 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

12 authors at 6 institutions in 1 country.

Gavin ChoHaematology and Sickle Cell Centre, London North West Healthcare NHS Trust, Central Middlesex Hospital, London, UK.
Kofi A AnieHaematology and Sickle Cell Centre, London North West Healthcare NHS Trust, Central Middlesex Hospital, London, UK Faculty of Medicine, Imperial College London, London, UK.
Jacky BucktonHaematology and Sickle Cell Centre, London North West Healthcare NHS Trust, Central Middlesex Hospital, London, UK.
Patricia KiiluHaematology and Sickle Cell Centre, London North West Healthcare NHS Trust, Central Middlesex Hospital, London, UK.
Mark LaytonDepartment of Haematology, Imperial College London, Hammersmith Hospital Campus, London, UK.
Lydia AlexanderDepartment of Haematology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
Claire HemmawayDepartment of Haematology, Barking, Havering and Redbridge University Hospitals NHS Trust, Queen's Hospital, Romford, Essex, UK.
Dorothy SuttonDepartment of Haematology, Barking, Havering and Redbridge University Hospitals NHS Trust, Queen's Hospital, Romford, Essex, UK.
Claire AmosMRC Clinical Trials Unit, University College London, London, UK.
Caroline J DoréMRC Clinical Trials Unit, University College London, London, UK.
Brennan KahanMRC Clinical Trials Unit, University College London, London, UK.
Sarah MeredithMRC Clinical Trials Unit, University College London, London, UK.
University College London · GBCentral Middlesex Hospital · GBHammersmith Hospital · GBLondon North West Healthcare NHS Trust · GBQueen's Hospital · GBMRC Clinical Trials Unit at UCL · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesSickle With Ibuprofen and Morphine (SWIM) trial was designed to assess whether co-administration of ibuprofen (a non-steroidal anti-inflammatory drug) resulted in a reduction of opioid consumption delivered by patient-controlled analgesia (PCA) for acute pain in sickle cell disease.

designA randomised, placebo-controlled, double-blind trial.

settingUK multicentre trial in acute hospital setting.

participantsAdults with sickle cell disease of any gender and phenotype aged 16 years and over.

interventionsOral ibuprofen at a dose of 800 mg three times daily or placebo in addition to opioids (morphine or diamorphine) administered via PCA pump for up to 4 days.

main outcome measuresThe primary outcome measure was opioid consumption over 4 days following randomisation.

resultsThe SWIM trial closed early because it failed to randomise to its target of 316 patients within a reasonable time.

conclusionsThe key issues identified include the unanticipated length of time between informed consent and randomisation, difficulties in randomisation of patients in busy emergency departments, availability of trained staff at weekends and out of hours, fewer centres than expected using PCA routinely for sickle cell pain treatment, lack of research staff and support for participation, and the trial design. There are implications for future UK trials in sickle cell disease. TRIAL REGISTRATION NUMBER: ISRCTN97241637, NCT00880373; Pre-results.

Indexed as

Administration, OralAdultAnalgesia, Patient-ControlledAnalgesics, OpioidAnemia, Sickle CellDouble-Blind MethodFemaleHumansIbuprofenMaleMiddle AgedMorphineOutcome Assessment, Health CarePainUnited KingdomAnalgesics, OpioidIbuprofenMorphineACCIDENT & EMERGENCY MEDICINEIBUPROFENOPIOIDSPAIN MANAGEMENTSICKLE CELL DISEASE

Identifiers

PMID27288381
PMCPMC4908891
OpenAlexW2418198749

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

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.