Innovations In Clinical Neuroscience

Pain Management August 2016

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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Hot Topics in Pain Management [August 2016] 18 ABSTRACT Background. The management of neuropathic pain (NP) is challenging despite it being the recent focus of extensive research. A number of clinical practice guidelines (CPGs) for the management of NP have been published worldwide over the past 2 decades. This study aimed to assess the quality of these CPGs. Methods. We performed a systematic review of published CPGs for the management of NP. Three reviewers independently assessed the quality of the CPGs using the Appraisal of Guidelines Research and Evaluation II (AGREE-II) instrument, and recommendations of CPGs were also appraised. Results. A total of 16 CPGs were included. Thirteen CPGs were developed using an evidence-based approach, and the remaining CPGs were produced by consensus panels. None of CPGs obtained a score greater than 50% in all six AGREE II instrument domains mainly owing to poor performance in the "Applicability" domain. The highest score of the CPGs was achieved in "Clarity and Presentation" domain, followed by "Scope and Purpose" and "Editorial Independence" domains, and the lowest scores were found the in "Applicability" domain. The majority of the CPG recommendations on the management of patients with NP were relatively consistent, especially regarding the recommendation of stepwise treatment with medication. Conclusion. Greater efforts are needed not only to improve the quality of development and presentation of the CPGs, but also to provide more efficacy evidence for the management of patients with NP. BACKGROUND Clinical practice guidelines (CPGs), defined as "statements that include recommendations intended to optimize patient care that are informed by a systematic review of the evidence and an assessment of the benefits and harms of alternative care options", have been expected to facilitate more consistent, effective and efficient medical practice, and ultimately improve health outcomes [1, 2]. Many organizations worldwide have Clinical Practice Guidelines for the Management of Neuropathic Pain: A Systematic Review BMC Anesthesiology BMC series 2016;16:12. DOI: 10.1186/s12871-015-0150-5 by YUNKUN DENG, 1,2 LEI LUO, 3 YUHUAI HU, 3 KAIYUN FANG, 1 and JIN LIU 2 1 Department of Anesthesiology, Guizhou Province People's Hospital; 2 Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University; 3 Department of Research and Education, Guizhou Province People's Hospital FUNDING: This study is supported by the FUNDING: This study is supported by the Guizhou Science and Technology Agency Fund (SY[2010]3122, LH[2015]7132) and Guiyang Administration of Science and Technology (2015001). COMPETING INTERESTS: The authors declare that they have no competing interests. KEY WORDS: Neuropathic pain. clinical KEY WORDS: Neuropathic pain. clinical KEY WORDS: Neuropathic pain. clinical practice guidelines, AGREE-II COPYRIGHT: © Deng et al. 2016. This article COPYRIGHT: © Deng et al. 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http:// creativecommons. org/ licenses/ by/ 4. 0), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http:// creativecommons. org/ publicdomain/ zero/ 1. 0/ ) applies to the data made available in this article, unless otherwise stated. in this article, unless otherwise stated. RECEIVED: 21 May 2015; ACCEPTED: 17 RECEIVED: 21 May 2015; ACCEPTED: 17 November 2015; PUBLISHED: 18 February 2016 R E S E A R C H

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