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Meta Analysis
Assay sensitivity and study features in neuropathic pain trials: an ACTTION meta-analysis.
- Robert H Dworkin, Dennis C Turk, Sarah Peirce-Sandner, Hua He, Michael P McDermott, John T Farrar, Nathaniel P Katz, Allison H Lin, Bob A Rappaport, and Michael C Rowbotham.
- Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. robert_dworkin@urmc.rochester.edu
- Neurology. 2013 Jul 2;81(1):67-75.
ObjectiveOur objective was to identify patient, study, and site factors associated with assay sensitivity in placebo-controlled neuropathic pain trials.MethodsWe examined the associations between study characteristics and standardized effect size (SES) in a database of 200 publicly available randomized clinical trials of pharmacologic treatments for neuropathic pain.ResultsThere was considerable heterogeneity in the SESs among the examined trials. Univariate meta-regression analyses indicated that larger SESs were significantly associated with trials that had 1) greater minimum baseline pain inclusion criteria, 2) greater mean subject age, 3) a larger percentage of Caucasian subjects, and 4) a smaller total number of subjects. In a multiple meta-regression analysis, the associations between SES and minimum baseline pain inclusion criterion and age remained significant.ConclusionsOur analyses have examined potentially modifiable correlates of study SES and shown that a minimum pain inclusion criterion of 40 or above on a 0 to 100 scale is associated with a larger SES. These data provide a foundation for investigating strategies to improve assay sensitivity and thereby decrease the likelihood of falsely negative outcomes in clinical trials of efficacious treatments for neuropathic pain.
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