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] 22 criteria; thus they had a limited effect on improving healthcare quality [2, 27]. Especially for CPGs published by developing regions, treatment recommendations were restricted by the limited availability of resources faced in the respective regions. The "Applicability" domain had a great effect on the implementation of CPGs. Additionally, the "Editorial Independence" domain refers to the most frequent sources of bias in the guidelines, and it was also found to be poor among the CPGs assessed in this study. Although the authors of guidelines might have economic ties with the pharmaceutical industry or even funding from pharmaceutical companies, most guidelines fail to provide information about potential conflicts of interest. Guidelines need to be evaluated not only for methodological quality but also for validity of their content in terms of recommendations. Thus, this study also analyzed the recommendations of these guidelines for the management of NP. In general, these recommendations were consistent on the diagnosis, assessment and pharmacological management despite scoring poorly in their rigor of development. It was difficult to tell whether we obtained these results because there was insufficient evidence to develop the guidelines or because the CPG authors did not search and make use of the best evidence available. A large number of the drug development research has been devoted to the field of NP. A large number of analgesic agents have shown efficacy for the treatment of NP. However, no more than 40–60% of patients have obtained sufficient pain relief with medications alone and in combination [11, 17]. Thus, it should be noted that treatment of patients with NP should be considered an integral component of a more comprehensive approach. In general, the guidelines for the management of NP vary considerably in terms of quality, because of the apparently low standards. To reduce the variability of the CPGs, guideline development groups should have standard methodology and strategy.

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