• Jason W Busse, Shanil Ebrahim, Gaelan Connell, Eric A Coomes, Paul Bruno, Keshena Malik, David Torrance, Trung Ngo, Karin Kirmayr, Daniel Avrahami, John J Riva, Peter Struijs, David Brunarski, Stephen J Burnie, Frances LeBlanc, Ivan A Steenstra, Quenby Mahood, Kristian Thorlund, Victor M Montori, Vishalini Sivarajah, Paul Alexander, Milosz Jankowski, Wiktoria Lesniak, Markus Faulhaber, Małgorzata M Bała, Stefan Schandelmaier, and Gordon H Guyatt.
• Department of Anesthesia, McMaster University, 1200 Main Street West, Hamilton, Ontario, L8S 4K1, Canada. bussejw@mcmaster.ca
• Syst Rev. 2013 Jan 1;2:18.

BackgroundFibromyalgia is associated with substantial socioeconomic loss and, despite considerable research including numerous randomized controlled trials (RCTs) and systematic reviews, there exists uncertainty regarding what treatments are effective. No review has evaluated all interventional studies for fibromyalgia, which limits attempts to make inferences regarding the relative effectiveness of treatments.Methods/DesignWe will conduct a network meta-analysis of all RCTs evaluating therapies for fibromyalgia to determine which therapies show evidence of effectiveness, and the relative effectiveness of these treatments. We will acquire eligible studies through a systematic search of CINAHL, EMBASE, MEDLINE, AMED, HealthSTAR, PsychINFO, PapersFirst, ProceedingsFirst, and the Cochrane Central Registry of Controlled Trials. Eligible studies will randomly allocate patients presenting with fibromyalgia or a related condition to an intervention or a control. Teams of reviewers will, independently and in duplicate, screen titles and abstracts and complete full text reviews to determine eligibility, and subsequently perform data abstraction and assess risk of bias of eligible trials. We will conduct meta-analyses to establish the effect of all reported therapies on patient-important outcomes when possible. To assess relative effects of treatments, we will construct a random effects model within the Bayesian framework using Markov chain Monte Carlo methods.DiscussionOur review will be the first to evaluate all treatments for fibromyalgia, provide relative effectiveness of treatments, and prioritize patient-important outcomes with a focus on functional gains. Our review will facilitate evidence-based management of patients with fibromyalgia, identify key areas for future research, and provide a framework for conducting large systematic reviews involving indirect comparisons.

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