The validity of average 8-h pain intensity assessment in cancer patients

IntroductionAromatase inhibitor-induced arthralgia (AIA) is a major adverse event of aromatase inhibitors (AIs) and leads to premature discontinuation of AI therapy in breast cancer patients. The objective of this protocol for a systematic review and network meta-analysis (NMA) is to provide the methodology to compare the change in pain intensity between different AIA treatments and demonstrate the rank probabilities for different treatments by combining all available direct and indirect evidence.Methods and analysisPubMed, the Cochrane Controlled Register of Trials (CENTRAL), EMBASE, Web of Science and ClinicalTrials.gov will be searched to identify publications in English from inception to November 2019. We will include randomised controlled trials (RCTs) assessing the effects of different treatments for AIA in postmenopausal women with stage 0–III hormone receptor-positive breast cancer. The primary endpoints will be the change in patient-reported pain intensity from baseline to post-treatment. The number of adverse events will be presented as a secondary outcome.Both pairwise meta-analysis and NMA with the Frequentist approach will be conducted. We will demonstrate summary estimates with forest plots in meta-analysis and direct and mixed evidence with a ranking of the treatments as the P-score in NMA. The revised Cochrane risk-of-bias tool for randomised trials will be used to assess the methodological quality within individual RCTs. The quality of evidence will be assessed.Ethics and disseminationAs this review does not involve individual patients, ethical approval is not required. The results of this systematic review and NMA will be published in a peer-reviewed journal. This review will provide valuable information on AIA therapeutic options for clinicians, health practitioners and breast cancer survivors.PROSPERO registration numberCRD42019136967.

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Meaningful cut-off pain intensity for breakthrough pain changes in advanced cancer patients

Current Medical Research and Opinion ◽

10.1185/03007995.2012.755120 ◽

2012 ◽

Vol 29 (1) ◽

pp. 93-97 ◽

Cited By ~ 27

Author(s):

Sebastiano Mercadante ◽

Claudio Adile ◽

Riccardo Torta ◽

Antonella Varetto ◽

Fabio Fulfaro ◽

...

Keyword(s):

Pain Intensity ◽

Cancer Patients ◽

Advanced Cancer ◽

Breakthrough Pain ◽

Advanced Cancer Patients

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A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid-Naive Cancer Patients: Results of the Korean South West Oncology Group Study

Pain Research and Management ◽

10.1155/2015/458389 ◽

2015 ◽

Vol 20 (6) ◽

pp. 293-299 ◽

Cited By ~ 3

Author(s):

Eun-Kee Song ◽

Hyunjeong Shim ◽

Hye-Suk Han ◽

DerSheng Sun ◽

Soon-Il Lee ◽

...

Keyword(s):

Quality Of Life ◽

Pain Relief ◽

Cancer Pain ◽

Pain Intensity ◽

Cancer Patients ◽

Pain Control ◽

Intensity Difference ◽

Front Line ◽

Long Acting

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long-acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid-naive cancer patients.OBJECTIVES: A prospective, open-label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front-line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long-acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate-release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per-protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid-naive cancer patients. As a single and front-line treatment, OROS hydromorphone delivered rapid pain control.

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Multi-modal data fusion for pain intensity assessment and classification

2017 Seventh International Conference on Image Processing Theory, Tools and Applications (IPTA) ◽

10.1109/ipta.2017.8310115 ◽

2017 ◽

Cited By ~ 4

Author(s):

Patrick Thiam ◽

Friedhelm Schwenker

Keyword(s):

Data Fusion ◽

Pain Intensity ◽

Modal Data ◽

Intensity Assessment

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Pain Intensity Assessment in Older Adults

Clinical Journal of Pain ◽

10.1097/00002508-200407000-00002 ◽

2004 ◽

Vol 20 (4) ◽

pp. 207-219 ◽

Cited By ~ 295

Author(s):

Keela A. Herr ◽

Kevin Spratt ◽

Paula R. Mobily ◽

Giovanna Richardson

Keyword(s):

Older Adults ◽

Pain Intensity ◽

Intensity Assessment

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Learning Spatial-Spectral-Temporal EEG Representations with Deep Attentive-Recurrent-Convolutional Neural Networks for Pain Intensity Assessment

Neuroscience ◽

10.1016/j.neuroscience.2021.11.034 ◽

2021 ◽

Author(s):

Fengjie Wu ◽

Weijian Mai ◽

Yisheng Tang ◽

Qingkun Liu ◽

Jiangtao Chen ◽

...

Keyword(s):

Neural Networks ◽

Pain Intensity ◽

Convolutional Neural Networks ◽

Intensity Assessment

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Amitriptyline in Neuropathic Cancer Pain in Patients on Morphine Therapy: A Randomized Placebo-controlled, Double-blind Crossover Study

Tumori Journal ◽

10.1177/030089160208800310 ◽

2002 ◽

Vol 88 (3) ◽

pp. 239-242 ◽

Cited By ~ 69

Author(s):

Sebastiano Mercadante ◽

Edoardo Arcuri ◽

Walter Tirelli ◽

Patrizia Villari ◽

Alessandra Casuccio

Keyword(s):

Quality Of Life ◽

Neuropathic Pain ◽

Adverse Effects ◽

Cancer Pain ◽

Pain Intensity ◽

Cancer Patients ◽

Double Blind ◽

Blind Crossover Study ◽

Double Blind Crossover Study

Aims and Background Amitriptyline is the most common analgesic adjuvant used in cancer patients with neuropathic pain, even though no specific studies have demonstrated a benefit. A randomized placebo-controlled, double-blind crossover study was designed to evidence the effects of amitriptyline in patients with neuropathic cancer pain. Methods Sixteen advanced cancer patients with neuropathic pain on systemic morphine therapy, no longer receiving oncologic treatment, presenting moderate pain (about 4 or more, but less than 7, on a numerical scale of 0-10) in the last week, and given a stable morphine dose in the last 2 days were admitted to the study. During the first week of study, patients were administered 25 mg of amitriptyline or equivalent drops of placebo at night for 3 days and 50 mg for the following 4 days. Doses for patients aged more than 65 years were 15 mg (first 3 days) and 30 mg (3 days after). After a week, a crossover took place for the second week, with the other treatment at an inverse sequence. Opioid consumption, pain intensity, symptoms and adverse effects, mood, sleep, patient's preference, quality of life before starting the study, the first week after and the second week after were recorded. Results No significant benefits in analgesia were found in the global pain intensity of the previous week of treatment, the least pain intensity or the pain evaluated just after a week of treatment, at the moment of the visit, when amitriptyline was compared with placebo. A significant difference was evidenced for the worst pain (P < 0.035). No differences in opioid doses during the period of study were found. Drowsiness, confusion and dry mouth were significantly more intense with amitriptyline than with placebo (P < 0.036, 0.003, and 0.034, respectively). There were no substantial differences between the two treatments in Spitzer's quality of life score and for each item. No differences in patients' preference for the two treatment periods were found. The analgesic effects of amitriptyline were slight and associated with adverse effects. Conclusions In light of the results obtained in the study, the extensive use of the drug for cancer pain should be questioned.

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