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"Evidence-Based Interventional Pain Medicine According to Clinical Diagnoses": Update 2018
Frank Huygen1, Jan Willem Kallewaard2, Maurits van Tulder3
1Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Summary
Updated guidelines for interventional pain medicine show minimal changes in recommendations for 113 treatments. Evidence quality and strength of recommendations for pain management options were evaluated.
Area of Science:
- Pain Medicine
- Evidence-Based Practice
- Clinical Guidelines
Background:
- A significant number of publications on evidence-based medicine for interventional pain medicine emerged between 2009 and 2011.
- The previous literature search necessitated an update to reflect new evidence in pain management.
Purpose of the Study:
- To update guidelines for interventional pain management based on the latest evidence.
- To evaluate the evolution of evidence quality and recommendation strength for interventional pain treatments.
Main Methods:
- An independent third party conducted a systematic literature search in 2015 using Cochrane and GRADE methodology.
- Guideline committee reviewed evidence, incorporating data from new studies and observational research published up to March 1st, 2018.
- Consideration of factors like side effects, complications, invasiveness, costs, and ethical aspects influenced recommendations.
Main Results:
- A total of 113 interventions for various pain diagnoses were assessed.
- Twenty-seven (24%) interventions were new compared to prior guidelines.
- Recommendations were modified for only 3 (2.6%) of the evaluated interventions, indicating high stability.
Conclusions:
- The updated guidelines reflect a comprehensive evaluation of interventional pain management options.
- The stability in recommendations suggests a robust evidence base for many established interventional pain treatments.
- This update provides current guidance for clinicians on evidence-based interventional pain medicine.