Evidence map›Paper›PMID 31639208›Full record

ArticleThe British journal of surgery2019

Population-based study of the prevalence and management of self-reported high pain scores in patients with non-resected pancreatic adenocarcinoma.

S Tung, N G Coburn, L E Davis, A L Mahar, S Myrehaug, H Zhao, C C Earle, A Nathens, J Hallet

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 40% 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

4 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
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

9 authors at 4 institutions in 1 country.

S TungDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.ORCID 0000-0002-6243-9794
N G CoburnDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
L E DavisSunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.
A L MaharDepartment of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
S MyrehaugDivisions of Radiation Oncology, Odette Cancer Centre, Toronto, Canada.
H ZhaoInstitute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
C C EarleDivisions of Medical Oncology, Odette Cancer Centre, Toronto, Ontario, Canada.
A NathensDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.
J HalletDivision of General Surgery, Department of Surgery, University of Toronto, Toronto, Canada.ORCID 0000-0001-5108-1072
Sunnybrook Health Science Centre · CAInstitute for Clinical Evaluative Sciences · CAUniversity of Manitoba · CAUniversity of Toronto · CA

Funding

CIHR FRN 154131
6 · The paper itself

Abstract

backgroundPain is a common debilitating symptom in pancreatic adenocarcinoma. This cohort study examined the use of, and factors associated with, pain-directed interventions for a high pain score in patients with non-curable pancreatic adenocarcinoma.

methodsAdministrative databases were linked and patients with non-resected pancreatic adenocarcinoma diagnosed between 2010 and 2016, who reported one or more Edmonton Symptom Assessment System (ESAS) score, were identified. A high pain score was defined as an ESAS score of at least 4. Outcomes were pain-directed interventions: opiates (in patients aged 65 years or more with universal drug coverage), nerve block and radiation therapy for a high pain score. Reduction in pain score of at least 1 point after pain-directed intervention was also evaluated. Modified Poisson regression was used to examine factors associated with pain-directed intervention.

resultsAmong 2623 patients with a median age of 67 years, 1223 (46·6 per cent) were women, and 1621 (61·8 per cent) reported a high pain score at a median of 38 days after diagnosis. Of those with a high pain score, 75·6 per cent (688 of 910) received opiates, 13·5 per cent (219 of 1621) radiation and 1·2 per cent (19 of 1621) nerve block. The pain score decreased in 62·1 per cent of patients after administration of opiates, 73·4 per cent after radiation and all patients after nerve block. In multivariable analysis, no patient factor (age, sex, co-morbidity burden, rurality, income quintile) was associated with receipt of non-opiate pain-directed intervention for a high pain score. In patients aged at least 65 years, advanced age was associated with lower odds of opiate use.

conclusionOpiates are the most common pain-directed intervention for non-curable pancreatic adenocarcinoma, whereas radiation therapy and nerve blocks are seldom used. The lack of association between pain-directed interventions and patient factors points toward practice-driven patterns.

Indexed as

AdenocarcinomaAgedAged, 80 and overAge FactorsAnalgesics, OpioidCancer PainFemaleHumansMaleMiddle AgedNerve BlockPain MeasurementPancreatic NeoplasmsRadiotherapyRetrospective StudiesSelf ReportAnalgesics, Opioid

Identifiers

PMID31639208
PMCPMC7938812
OpenAlexW2981602843

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.