The Clinical journal of pain
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Meta Analysis
Predictors of placebo response in pooled lamotrigine neuropathic pain clinical trials.
One limitation of neuropathic pain clinical trials is the often large and variable extent of response in the placebo group, possibly obscuring true medication effects. We pooled data from 252 individuals in the placebo arms of 3 clinical trials of lamotrigine in patients with neuropathic pain to examine the relationship of baseline patient and study site characteristics with 12-week change in the Pain Intensity Numerical Rating Scale score (DeltaPI-NRS). The 574 patients in the pooled lamotrigine treatment arms were used as a replication dataset. ⋯ These results suggest that both patient and study site characteristics can influence the response in the placebo arms of neuropathic pain studies.
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Review Meta Analysis
The diagnostic accuracy of brief screening questions for psychosocial risk factors of poor outcome from an episode of pain: A systematic review.
To determine the diagnostic accuracy of brief screening questions for psychosocial risk factors predictive of poor outcome from an episode of pain. ⋯ Data were only available on the accuracy of brief screening instruments for depression and anxiety, and there was variability in the results. Head-to-head studies are required to determine if this variability reflects differential question accuracy or population characteristics, and studies that determine the diagnostic accuracy of brief screening questions for other common psychosocial risk factors would be useful.
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Review Meta Analysis
Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review of the literature.
Trigger points are promoted as an important cause of musculoskeletal pain. There is no accepted reference standard for the diagnosis of trigger points, and data on the reliability of physical examination for trigger points are conflicting. ⋯ No study to date has reported the reliability of trigger point diagnosis according to the currently proposed criteria. On the basis of the limited number of studies available, and significant problems with their design, reporting, statistical integrity, and clinical applicability, physical examination cannot currently be recommended as a reliable test for the diagnosis of trigger points. The reliability of trigger point diagnosis needs to be further investigated with studies of high quality that use current diagnostic criteria in clinically relevant patients.
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Review Meta Analysis
Are manual therapies effective in reducing pain from tension-type headache?: a systematic review.
A systematic review was performed to establish whether manual therapies have specific efficacy in reducing pain from tension-type headache (TTH). ⋯ The authors found no rigorous evidence that manual therapies have a positive effect in the evolution of TTH. The most urgent need for further research is to establish the efficacy beyond placebo of the different manual therapies currently applied in patients with TTH.
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Review Meta Analysis
Are reports of childhood abuse related to the experience of chronic pain in adulthood? A meta-analytic review of the literature.
Recent empirical evidence suggests that childhood abuse may be related to the experience of chronic pain in adulthood. To date, a systematic quantitative review of the literature has not been presented. ⋯ Results provide evidence that individuals who report abusive or neglectful childhood experiences are at increased risk of experiencing chronic pain in adulthood relative to individuals not reporting abuse or neglect in childhood.