PROSPECT methodology for developing procedure-specific pain management recommendations: an update

Area of Science:

• Pain Management
• Evidence-Based Medicine
• Clinical Practice Guidelines

Background:

• The Procedure-Specific Postoperative Pain Management (PROSPECT) working group provides evidence-based recommendations.
• Existing PROSPECT methodology has limitations and areas for improvement.
• New factors have been identified to enhance the methodology.

Purpose of the Study:

• To present updated PROSPECT methodology for developing procedure-specific pain management recommendations.
• To detail methodological revisions for improved rigor and transparency.
• To outline future PROSPECT working group procedures.

Main Methods:

• Implementing prospective registration of randomized clinical trials.
• Excluding specific placebo-controlled studies (paracetamol, NSAIDs, COX-2 inhibitors, opioids) and drug-class comparisons.
• Utilizing the Cochrane Collaboration risk of bias tool for quality assessment.
• Employing a modified Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach for evidence and recommendations.

Main Results:

• The updated methodology incorporates prospective trial registration.
• Specific study designs and drug comparisons will be excluded from future reviews.
• Enhanced tools for assessing evidence quality and recommendation strength will be used.

Conclusions:

• The revised PROSPECT methodology increases rigor and transparency in developing pain management guidelines.
• Updated procedures ensure a more robust and reliable evidence-based approach.
• These changes will lead to improved procedure-specific pain management recommendations.