Pain
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Meta Analysis
Quantitative sensory testing in patients with migraine: a systematic review and meta-analysis.
Quantitative sensory testing (QST) is widely used to assess somatosensory function by application of controlled stimuli across a variety of modalities. The aim of the present meta-analysis is to synthesize QST results across a wide array of studies of patients with migraine to identify the QST parameters that are reliably different between patients with migraine and healthy controls. In addition, we aimed to determine whether such differences vary according to stimulus location. ⋯ In addition, patients with migraine had higher pain ratings to cold suprathreshold stimuli for combined and nonlocal areas, and higher pain ratings to electrical suprathreshold stimuli for nonlocal areas. This meta-analysis indicates that the alterations in nociceptive processing of patients with migraine may be modality, measure, and location specific. These results provide researchers and clinicians the evidence to choose QST parameters optimally suited for differentiating patients with migraine and healthy controls.
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Neuropathic pain (NP) is an increasingly common chronic pain state and a major health burden, affecting approximately 7% to 10% of the general population. Emerging evidence suggests that genetic factors could partially explain individual susceptibility to NP and the estimated heritability in twins is 37%. The aim of this study was to systematically review and summarize the studies in humans that have investigated the influence of genetic factors associated with NP. ⋯ These findings demonstrate an important and specific contribution of genetic factors to the risk of developing NP. However, large-scale replication studies are required to validate these candidate genes. Our review also highlights the need for genome-wide association studies with consistent case definition to elucidate the genetic architecture underpinning NP.
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Review Meta Analysis
The effectiveness of online pain resources for health professionals: a systematic review with subset meta-analysis of educational intervention studies.
Online educational interventions are increasingly developed for health professionals and students, although graduate and undergraduate medical curricula often contain limited information about how to assess and manage pain. This study reviews the literature on the effectiveness of pain-related online educational resources. Studies were identified through a search of Medline, PsychINFO, Web of Science, CINAHL, PubMed, Scopus, Cochrane Library, Google Scholar, and OpenGrey databases. ⋯ Although online educational resources show promise in improving learner knowledge, considerable heterogeneity exists between studies in quality, design, educational content, and outcomes. Furthermore, methodologically robust RCTs are required to establish the effectiveness of online educational interventions and a greater understanding of the key features of successful online resources, including cognitive interactivity. Few studies assessed health outcomes for patients, remaining a major priority for future investigations.
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Review Meta Analysis
Surgical interventions for the treatment of painful neuroma: a comparative meta-analysis.
A consensus on the optimal treatment of painful neuromas does not exist. Our objective was to identify available data and to examine the role of surgical technique on outcomes following surgical management of painful neuromas. In accordance with the PRISMA guidelines, we performed a comprehensive literature search to identify studies measuring the efficacy of the surgical treatment of painful neuromas in the extremities (excluding Morton's neuroma and compression neuropathies). ⋯ No significant differences were seen between surgical techniques. Among studies with a mean pain duration greater than 24 months, or median number of operations greater than 2 prior to definitive neuroma pain surgery, excision and transposition or neurolysis and coverage were significantly more likely than other operative techniques to result in a meaningful reduction in pain (P < 0.05). Standardization in the reporting of surgical techniques, outcomes, and confounding factors is needed in future studies to enable providers to make comparisons across disparate techniques in the surgical treatment of neuroma pain.
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Review Meta Analysis
Defining chronic pain in epidemiological studies - a systematic review and meta-analysis.
The objective was to document the operational definitions applied in epidemiological studies of chronic pain and to examine whether pain definitions and other methodological factors are systematically related to prevalence estimates. MEDLINE, EMBASE, and PsychINFO were searched for original research reports with study samples of at least 1000 individuals, excluding studies of less than 5 out of 15 selected body regions and studies solely concerned with specific pain conditions. Meta-analyses and meta-regressions were applied with random effects models; covariates were geography, sampling year, survey method, sampling frame, participation rate, percentage women of all participants, pain duration, and pain location. ⋯ There were also interaction effect of survey method by sex (female-male prevalence ratio [95% confidence interval]: questionnaire = 1.20 [1.16 to 1.25], and interview = 1.38 [1.29 to 1.47]). The other covariates investigated were not significantly related to the prevalence estimates. Researchers and clinicians should be aware of the probability that interview survey method of collecting data may give lower chronic pain reporting than questionnaire survey method and that this effect may be stronger in men than women.