Articles: pain-measurement.
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Randomized Controlled Trial Clinical Trial
Defining the clinically important difference in pain outcome measures.
The purpose of this study was to determine the levels of change on standard pain scales that represent clinically important differences to patients. Data from analgesic studies are often difficult to interpret because the clinical importance of the results is not obvious. Differences between groups, as summarized by a change in mean values over time, can be difficult to apply to clinical care. ⋯ This study presents data-derived cut-off points for the changes in several pain scales, each reflecting the clinically important improvement for patients treating breakthrough cancer pain episodes with OTFC. Confirmation in other patient populations and different pain syndromes will be needed. The use of consistent clinically important cut-off points as the primary outcome in future pain therapy clinical trials will enhance their validity, comparability, and clinical applicability.
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Randomized Controlled Trial Multicenter Study Clinical Trial
An educational implementation of a cancer pain algorithm for ambulatory care.
Algorithms are proposed as a means of operationalizing guidelines or standards for cancer pain management. Professional education is used as the means to translate knowledge into practice. Outcomes measurement is the gold standard for validating improvement. ⋯ There was a clear deterioration in the impact of the training over time. The most significant effect occurred within the first 140 days after the intervention and was followed by a gradual return to baseline practice. In conclusion, algorithmic interventions can be successfully transferred into community practice, but further work must be performed to develop methods for securing retention of knowledge and maintaining improved outcomes.
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Oral Surg Oral Med O · Nov 2000
Randomized Controlled Trial Comparative Study Clinical TrialComparison of methods for measuring root and mucogingival sensitivity.
The aim of this study was to compare the variability of measurements of root and mucogingival sensitivity over a 24-hour period. ⋯ Calibrated cold stimulation of root areas appears to provide the most sensitive measure to assess therapeutic interventions to control cervical dental pain because of low intrasubject variability in untreated patients.
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J Pain Symptom Manage · Oct 2000
Randomized Controlled Trial Clinical TrialAnalgesic effect of intravenous ketamine in cancer patients on morphine therapy: a randomized, controlled, double-blind, crossover, double-dose study.
Pain not responsive to morphine is often problematic. Animal and clinical studies have suggested that N-methyl-D-aspartate (NMDA) antagonists, such as ketamine, may be effective in improving opioid analgesia in difficult pain syndromes, such as neuropathic pain. A slow bolus of subhypnotic doses of ketamine (0.25 mg/kg or 0.50 mg/kg) was given to 10 cancer patients whose pain was unrelieved by morphine in a randomized, double-blind, crossover, double-dose study. ⋯ Ketamine can improve morphine analgesia in difficult pain syndromes, such as neuropathic pain. However, the occurrence of central adverse effects should be taken into account, especially when using higher doses. This observation should be tested in studies of prolonged ketamine administration.
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Randomized Controlled Trial Clinical Trial
Effect of acupuncture upon experimentally induced ischemic pain: a sham-controlled single-blind study.
To investigate the hypoalgesic effect of true and sham acupuncture upon experimentally induced ischemic pain. ⋯ The results of the study provide no convincing evidence for a superior hypoalgesic effect of acupuncture compared with "sham" procedures on this model of experimental pain.