Evidence map›Paper›PMID 34588811›Full record

ArticleJournal of pain research2021

Scoping Review of Off-Label Topical Analgesia in Palliative, Hospice and Cancer Care: Towards Flexibility in Evidence-Based Medicine.

Baraa O Tayeb, Jennifer A Winegarden, Rawabi A Alashari, Moudi Alasmari, Jonathan Winegarden, Faisal Boker, Abdulaziz Halawi, Amy Lapidow, Ylisabyth S Bradshaw, Daniel B Carr

Abstract readScoping Review
In one paragraph

Article in Journal of pain research, 2021. 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
–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

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

  1. Pooled it
  2. 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

10 authors.

Baraa O TayebDepartment of Anesthesiology and Critical Care, King Abdulaziz University Faculty of Medicine, Jeddah, Saudi Arabia.ORCID 0000-0001-5634-1531
Jennifer A WinegardenDepartment of Medicine, The Medical Team Hospice, Livonia, MI, USA.ORCID 0000-0002-1717-4803
Rawabi A AlashariDepartment of Pharmacology, King Abdulaziz University, Faculty of Medicine, Jeddah, Saudi Arabia.
Moudi AlasmariCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.ORCID 0000-0002-2962-8737
Jonathan WinegardenDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
Faisal BokerEmergency Department, King Abdulaziz Medical City-Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia.
Abdulaziz HalawiKing Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Amy LapidowTufts Hirsh Health Sciences Library, Boston, MA, USA.
Ylisabyth S BradshawDepartment of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.
Daniel B CarrDepartment of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA.ORCID 0000-0002-8351-9785

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeScoping reviews address the nature of the literature per se rather than inferring evidence-based treatment guidelines. Scoping reviews of the published literature are intended to describe the aggregated nature of the evidence surrounding some agent or intervention, in contrast to systematic reviews that seek when possible to guide clinical practice. We conducted a scoping review to identify reports of potential clinical utility of off-label topical analgesics and adjuvants when FDA-approved treatments have proven inadequate.

methodsWe performed a comprehensive search of three databases (PubMed, Web of Science and Embase) for articles dating from 1947 to the present. Mindful that FDA-approved and WHO-recommended analgesic medications often prove inadequate for individual patients in extremis with palliative, hospice or cancer pain, we used broad, structured inclusion criteria to retrieve articles.

resultsWe retrieved 12,100 articles; after screening, we had 39 reports addressing 19 different topical agents out of the 32 chemical entities. Our scoping review disclosed evidence about agents that might not have met inclusion criteria for clinical practice guidelines. DISCUSSION: Although generally considered lower quality evidence, case reports or series present suggestions for diverse topical medications to manage pain in challenging circumstances when high-quality evidence for agents and routes of administration is lacking.

conclusionPatients with the greatest need for evidence to identify and guide lesser-used agents during aggressive pain management are the most difficult to enroll and follow in standardized, controlled and/or blinded clinical trials. This scoping review identifies medications, dosages, and routes of topical agents reported to be effective in these often-challenging circumstances. Until larger and higher quality studies are completed, we must rely on the best available evidence even if of lower quality.

Indexed as

analgesiacancerevidence-based medicinehospicepainpalliative carepersonalized medicinetopical medications

Identifiers

PMID34588811
PMCPMC8473564

What OpenQuestion holds

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Registered trials

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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.