Evidence map›Paper›PMID 39267131›Full record

ArticleSystematic reviews2024

The impact of chiropractic care on prescription opioid use for non-cancer spine pain: protocol for a systematic review and meta-analysis.

Peter C Emary, Kelsey L Corcoran, Brian C Coleman, Amy L Brown, Carla Ciraco, Jenna DiDonato, Li Wang, Rachel J Couban, Abhimanyu Sud, Jason W Busse

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Systematic reviews, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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. Review
  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.

Peter C EmaryMichael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON, Canada. emaryp@mcmaster.ca.
Kelsey L CorcoranYale School of Medicine, New Haven, CT, USA.
Brian C ColemanPain, Research, Informatics, Medical Comorbidities, and Education (PRIME) Center, Veterans Affairs of Connecticut Healthcare System, West Haven, CT, USA.
Amy L BrownPrivate Practice, Cambridge, ON, N3H 4L5, Canada.
Carla CiracoPrivate Practice, Vaughan, ON, Canada.
Jenna DiDonatoPrivate Practice, Ancaster, ON, Canada.
Li WangMichael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada.
Rachel J CoubanMichael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada.
Abhimanyu SudDepartment of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
Jason W BusseMichael G. DeGroote National Pain Centre, McMaster University, Hamilton, ON, Canada.

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

backgroundIn recent studies, receipt of chiropractic care has been associated with lower odds of receiving prescription opioids and, among those already prescribed, reduced doses of opioids among patients with non-cancer spine pain. These findings suggest that access to chiropractic services may reduce reliance on opioids for musculoskeletal pain.

objectiveTo assess the impact of chiropractic care on initiation, or continued use, of prescription opioids among patients with non-cancer spine pain.

methodsWe will search for eligible randomized controlled trials (RCTs) and observational studies indexed in MEDLINE, Embase, AMED, CINAHL, Web of Science, and the Index to Chiropractic Literature from database inception to June 2024. Article screening, data extraction, and risk-of-bias assessment will be conducted independently by pairs of reviewers. We will conduct separate analyses for RCTs and observational studies and pool binary outcomes (e.g. prescribed opioid receipt, long-term opioid use, and higher versus lower opioid dose) as odds ratios (ORs) with associated 95% confidence intervals (CIs). When studies provide hazard ratios (HRs) or relative risks (RRs) for time-to-event data (e.g. time-to-first opioid prescription) or incidence rates (number of opioid prescriptions over time), we will first convert them to an OR before pooling. Continuous outcomes such as pain intensity, sleep quality, or morphine equivalent dose will be pooled as weighted mean differences with associated 95% CIs. We will conduct meta-analyses using random-effects models and explore sources of heterogeneity using subgroup analyses and meta-regression. We will evaluate the certainty of evidence of all outcomes using the GRADE approach and the credibility of all subgroup effects with ICEMAN criteria. Our systematic review will follow the PRISMA statement and MOOSE guidelines. DISCUSSION: Our review will establish the current evidence informing the impact of chiropractic care on new or continued prescription opioid use for non-cancer spine pain. We will disseminate our results through peer-reviewed publication and conference presentations. The findings of our review will be of interest to patients, health care providers, and policy-makers.

trial registrationSystematic review registration: PROSPERO CRD42023432277.

Indexed as

Analgesics, OpioidManipulation, ChiropracticBack PainHumansMeta-Analysis as TopicMusculoskeletal PainSystematic Reviews as TopicAnalgesics, OpioidChiropracticMeta-analysisOpioidSpine painSystematic review

Identifiers

PMID39267131
PMCPMC11394937

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.