Analgesic Safety - Myths, Mysteries and Misconceptions
Analgesic Safety - Myths, Mysteries and Misconceptions
When we look at data, is it important to look in the context of methodology of clinical studies in pain management? Healthcare providers often look to systematic reviews to inform their decision-making. Good meta-analyses are useful because they increase the power and precision of treatment-effect and exposure-risk estimates. However, the reliability and accuracy of the conclusions depend on the quality of the primary data, and the measures taken to reduce bias and to control for confounding factors. Gerber et al. identified considerable methodological deficiencies in many meta-analyses published in leading journals; for example, only 52% made any attempt at assessing trial quality, and assessment of randomisation and blinding was carried out in only 31%. As a result, many systematic reviews in the analysis by Gerber et al. probably overstated any treatment effects.
At OTC doses, ibuprofen is a better analgesic than paracetamol, and any concerns about harm are probably based on a misunderstanding of the evidence
Observational studies are often considered inferior to randomised controlled trials (RCTs) because of the potential for selection bias and confounding. Yet they have a crucial role to play when it comes to assessing the true incidence of drug-related toxicities, for instance [especially for events that are comparatively rare, as is the case with serious GI or cardiovascular (CV) complications]. The general perception that observational studies lead to an overestimation of treatment effects has been refuted by Concato et al., who showed that well-designed observational studies give the same results as well-designed RCTs, and where there was a sufficiency of evidence to make a judgement.
Methodological Considerations
When we look at data, is it important to look in the context of methodology of clinical studies in pain management? Healthcare providers often look to systematic reviews to inform their decision-making. Good meta-analyses are useful because they increase the power and precision of treatment-effect and exposure-risk estimates. However, the reliability and accuracy of the conclusions depend on the quality of the primary data, and the measures taken to reduce bias and to control for confounding factors. Gerber et al. identified considerable methodological deficiencies in many meta-analyses published in leading journals; for example, only 52% made any attempt at assessing trial quality, and assessment of randomisation and blinding was carried out in only 31%. As a result, many systematic reviews in the analysis by Gerber et al. probably overstated any treatment effects.
At OTC doses, ibuprofen is a better analgesic than paracetamol, and any concerns about harm are probably based on a misunderstanding of the evidence
Observational studies are often considered inferior to randomised controlled trials (RCTs) because of the potential for selection bias and confounding. Yet they have a crucial role to play when it comes to assessing the true incidence of drug-related toxicities, for instance [especially for events that are comparatively rare, as is the case with serious GI or cardiovascular (CV) complications]. The general perception that observational studies lead to an overestimation of treatment effects has been refuted by Concato et al., who showed that well-designed observational studies give the same results as well-designed RCTs, and where there was a sufficiency of evidence to make a judgement.
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