Article type
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Abstract
Background: More and more attention has been paid to the research of postoperative analgesia, and large numbers of systematic reviews (SRs) of postoperative analgesia have been published in Cochrane Database of Systematic Reviews. However, what outcome measures these reviews reported is unknown.
Objectives: To explore the distribution of outcome measures reported by Cochrane reviews of postoperative analgesia.
Methods: Cochrane Database of Systematic Reviews (Issue 3 of 12, March 2012) was searched for SRs of postoperative analgesia with the search terms ‘postoperative pain’ and ‘postoperative analgesia’ being used. SRs not focusing on postoperative analgesia or not reporting outcomes associated with postoperative analgesia were excluded. Outcome measures of included SRs were recorded.
Results: Of 42 SRs that proved eligible, 34 (81%) were edited by Cochrane Pain, Palliative and Supportive Care Group, 3 (7%) by Cochrane Anaesthesia Group, and 5 (12%) by other editorial groups. A total of 13 outcomes were reported by the included SRs (Fig. 1), and each SR reported a median of 4 (range: 2–7) outcomes. Adverse events (93%, 39/42), patients achieving at least 50% pain relief (74%, 31/42), patients using rescue medication (69%, 29/42) and time to use rescue medication (52%, 22/42) were the most commonly reported outcomes, of which most are surrogate outcomes. However, patient-important outcomes, such as pain intensity, patient satisfaction and postoperative mortality were reported only in 24% (10/42), 17% (7/42), 2% (1/42) SRs, respectively. Hospital stay was the unique economic outcome reported by the SRs, which was reported by six SRs (14%).
Conclusions: Surrogate outcomes were reported by most Cochrane reviews of postoperative analgesia, with patient-important outcomes being reported at a very low proportion. Researchers should pay more attention on patient-important and economic outcomes when conducting clinical trails and SRs of postoperative analgesia.
Objectives: To explore the distribution of outcome measures reported by Cochrane reviews of postoperative analgesia.
Methods: Cochrane Database of Systematic Reviews (Issue 3 of 12, March 2012) was searched for SRs of postoperative analgesia with the search terms ‘postoperative pain’ and ‘postoperative analgesia’ being used. SRs not focusing on postoperative analgesia or not reporting outcomes associated with postoperative analgesia were excluded. Outcome measures of included SRs were recorded.
Results: Of 42 SRs that proved eligible, 34 (81%) were edited by Cochrane Pain, Palliative and Supportive Care Group, 3 (7%) by Cochrane Anaesthesia Group, and 5 (12%) by other editorial groups. A total of 13 outcomes were reported by the included SRs (Fig. 1), and each SR reported a median of 4 (range: 2–7) outcomes. Adverse events (93%, 39/42), patients achieving at least 50% pain relief (74%, 31/42), patients using rescue medication (69%, 29/42) and time to use rescue medication (52%, 22/42) were the most commonly reported outcomes, of which most are surrogate outcomes. However, patient-important outcomes, such as pain intensity, patient satisfaction and postoperative mortality were reported only in 24% (10/42), 17% (7/42), 2% (1/42) SRs, respectively. Hospital stay was the unique economic outcome reported by the SRs, which was reported by six SRs (14%).
Conclusions: Surrogate outcomes were reported by most Cochrane reviews of postoperative analgesia, with patient-important outcomes being reported at a very low proportion. Researchers should pay more attention on patient-important and economic outcomes when conducting clinical trails and SRs of postoperative analgesia.
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