Evidence map›Paper›PMID 38388015›Full record

SynthesisRegional anesthesia and pain medicine2025

Methodological and statistical characteristics of meta-analyses on spinal cord stimulation for chronic pain: a systematic review.

Donald J Kleppel, Royce Copeland, Nasir Hussain, Jay Karri, Eric Wang, Ryan S D'Souza

Abstract readSystematic Review
In one paragraph

Synthesis in Regional anesthesia and pain medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the 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
–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

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

  1. Pooled it
  2. Article
  3. Article
  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

6 authors.

Donald J KleppelDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0002-1864-3384
Royce CopelandDepartment of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.ORCID 0000-0001-9709-5285
Nasir HussainDepartment of Anesthesiology, The Ohio State University, Wexner Medical Center, Columbus, Ohio, USA.
Jay KarriDepartments of Orthopedic Surgery and Anesthesiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Eric WangDepartment of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-9381-9554
Ryan S D'SouzaDepartment of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA DSouza.Ryan@mayo.edu.ORCID 0000-0002-4601-9837

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA growing number of meta-analyses (MA) have investigated the use of spinal cord stimulation (SCS) as a treatment modality for chronic pain. The quality of these MAs has not been assessed by validated appraisal tools.

objectiveTo examine the methodological characteristics and quality of MAs related to the use of SCS for chronic pain syndromes. EVIDENCE REVIEW: An online literature search was conducted in Ovid MEDLINE(R), Ovid EMBASE, Ovid Cochrane Database of Systematic Reviews, and Scopus databases (January 1, 2000 through June 30, 2023) to identify MAs that investigated changes in pain intensity, opioid consumption, and/or physical function after SCS for the treatment of chronic pain. MA quality was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) critical appraisal tool.

findingsTwenty-five MAs were appraised in the final analysis. Three were considered "high" quality, three "low" quality, and 19 "critically low" quality, per the AMSTAR-2 criteria. There was no association between the publication year and AMSTAR-2 overall quality (β 0.043; 95% CI -0.008 to 0.095; p=0.097). There was an association between the impact factor and AMSTAR-2 overall quality (β 0.108; 95% CI 0.044 to 0.172; p=0.002), such that studies published in journals with higher impact factors were associated with higher overall quality. There was no association between the effect size and AMSTAR-2 overall quality (β -0.168; 95% CI -0.518 to 0.183; p=0.320).According to our power analysis, three studies were adequately powered (>80%) to reject the null hypothesis, while the remaining studies were underpowered (<80%).

conclusionsThe study demonstrates a critically low AMSTAR-2 quality for most MAs published on the use of SCS for treating chronic pain. Future MAs should improve study quality by implementing the AMSTAR-2 checklist items. PROSPERO REGISTRATION NUMBER: CRD42023431155.

Indexed as

Chronic PainMeta-Analysis as TopicPain ManagementSpinal Cord StimulationHumansPain MeasurementTreatment OutcomeanalgesiaCHRONIC PAINPain ManagementSpinal Cord Stimulation

Identifiers

PMID38388015
PMCPMC12015056

What OpenQuestion holds

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LicenceCC BY-NC
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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.