Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials

Introduction Chronic, non-cancer, axial or radicular spinal pain is a common condition associated with considerable socioeconomic burden. Clinicians frequently offer patients various interventional procedures for the treatment of chronic spine pain; however, the comparative effectiveness and safety...

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Main Authors: Xiaoqin Wang, Jason W Busse, Behnam Sadeghirad, Gordon H Guyatt, Thomas Agoritsas, Ivan D Florez, Yaping Chang, Elena Kum, Y Raja Rampersaud, D Norman Buckley, Andrea J Darzi, Grace Martin, Rachel J Couban, Holly N Crandon, Meisam Abdar Esfahani, Laxsanaa Sivananthan, Fatemeh Mehrabi, Neil K Sengupta, Preksha Rathod, Rami Z Morsi, Christopher J Standaert
Format: Article
Language:English
Published: BMJ Publishing Group 2021-07-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/7/e046025.full
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author Xiaoqin Wang
Jason W Busse
Behnam Sadeghirad
Gordon H Guyatt
Thomas Agoritsas
Ivan D Florez
Yaping Chang
Elena Kum
Y Raja Rampersaud
D Norman Buckley
Andrea J Darzi
Grace Martin
Rachel J Couban
Holly N Crandon
Meisam Abdar Esfahani
Laxsanaa Sivananthan
Fatemeh Mehrabi
Neil K Sengupta
Preksha Rathod
Rami Z Morsi
Christopher J Standaert
author_facet Xiaoqin Wang
Jason W Busse
Behnam Sadeghirad
Gordon H Guyatt
Thomas Agoritsas
Ivan D Florez
Yaping Chang
Elena Kum
Y Raja Rampersaud
D Norman Buckley
Andrea J Darzi
Grace Martin
Rachel J Couban
Holly N Crandon
Meisam Abdar Esfahani
Laxsanaa Sivananthan
Fatemeh Mehrabi
Neil K Sengupta
Preksha Rathod
Rami Z Morsi
Christopher J Standaert
author_sort Xiaoqin Wang
collection DOAJ
description Introduction Chronic, non-cancer, axial or radicular spinal pain is a common condition associated with considerable socioeconomic burden. Clinicians frequently offer patients various interventional procedures for the treatment of chronic spine pain; however, the comparative effectiveness and safety of available procedures remains uncertain.Methods We will conduct a systematic review of randomised controlled trials that explores the effectiveness and harms of interventional procedures for the management of axial or radicular, chronic, non-cancer, spine pain. We will identify eligible studies through a systematic search of Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science from inception without language restrictions. Eligible trials will: (1) enrol primarily adult patients (≥18 years old) with axial or radicular, chronic, non-cancer, spine pain, (2) randomise patients to different, currently available, interventional procedures or to an interventional procedure and a placebo/sham procedure or usual care, and (3) measure outcomes at least 1 month after randomisation.Pairs of reviewers will independently screen articles identified through searches and extract information and assess risk of bias of eligible trials. We will use a modified Cochrane instrument to evaluate risk of bias. We will use frequentist random-effects network meta-analyses to assess the relative effects of interventional procedures, and five a priori hypotheses to explore between studies subgroup effects. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in evidence for each outcome, including direct, indirect and network estimates.Ethics and dissemination No research ethics approval is required for this systematic review, as no confidential patient data will be used. We will disseminate our findings through publication in a peer-reviewed journal and conference presentations, and our review will support development of a BMJ Rapid Recommendations providing contextualised clinical guidance based on this body of evidence.PROSPERO registration number CRD42020170667.
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spelling doaj-art-8032e71a165f4437b7afd70a754bef282025-08-20T01:47:26ZengBMJ Publishing GroupBMJ Open2044-60552021-07-0111710.1136/bmjopen-2020-046025Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trialsXiaoqin Wang0Jason W Busse1Behnam Sadeghirad2Gordon H Guyatt3Thomas Agoritsas4Ivan D Florez5Yaping Chang6Elena Kum7Y Raja Rampersaud8D Norman Buckley9Andrea J Darzi10Grace Martin11Rachel J Couban12Holly N Crandon13Meisam Abdar Esfahani14Laxsanaa Sivananthan15Fatemeh Mehrabi16Neil K Sengupta17Preksha Rathod18Rami Z Morsi19Christopher J Standaert20Department of Nursing, Xi`an Jiaotong University Health Science Center, Xi`an, Shaanxi, ChinaHealth Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canadainternist, methodologistinternist, methodologistassociate professorDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, CanadaHealth Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, CanadaArthritis Program, Krembil Research Institute, Division of Orthopaedics, University Health Network, Toronto, Ontario, CanadaAnesthesia, McMaster University, Hamilon, Ontario, CanadaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canadamedical studentlibrarianMBiotech candidateDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, CanadaGraduate Entry Medical School, University of Limerick, Limerick, IrelandPharmaceutic Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, IranMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, CanadaMichael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, CanadaUniversity of Chicago, Chicago, USADepartment of Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USAIntroduction Chronic, non-cancer, axial or radicular spinal pain is a common condition associated with considerable socioeconomic burden. Clinicians frequently offer patients various interventional procedures for the treatment of chronic spine pain; however, the comparative effectiveness and safety of available procedures remains uncertain.Methods We will conduct a systematic review of randomised controlled trials that explores the effectiveness and harms of interventional procedures for the management of axial or radicular, chronic, non-cancer, spine pain. We will identify eligible studies through a systematic search of Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science from inception without language restrictions. Eligible trials will: (1) enrol primarily adult patients (≥18 years old) with axial or radicular, chronic, non-cancer, spine pain, (2) randomise patients to different, currently available, interventional procedures or to an interventional procedure and a placebo/sham procedure or usual care, and (3) measure outcomes at least 1 month after randomisation.Pairs of reviewers will independently screen articles identified through searches and extract information and assess risk of bias of eligible trials. We will use a modified Cochrane instrument to evaluate risk of bias. We will use frequentist random-effects network meta-analyses to assess the relative effects of interventional procedures, and five a priori hypotheses to explore between studies subgroup effects. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in evidence for each outcome, including direct, indirect and network estimates.Ethics and dissemination No research ethics approval is required for this systematic review, as no confidential patient data will be used. We will disseminate our findings through publication in a peer-reviewed journal and conference presentations, and our review will support development of a BMJ Rapid Recommendations providing contextualised clinical guidance based on this body of evidence.PROSPERO registration number CRD42020170667.https://bmjopen.bmj.com/content/11/7/e046025.full
spellingShingle Xiaoqin Wang
Jason W Busse
Behnam Sadeghirad
Gordon H Guyatt
Thomas Agoritsas
Ivan D Florez
Yaping Chang
Elena Kum
Y Raja Rampersaud
D Norman Buckley
Andrea J Darzi
Grace Martin
Rachel J Couban
Holly N Crandon
Meisam Abdar Esfahani
Laxsanaa Sivananthan
Fatemeh Mehrabi
Neil K Sengupta
Preksha Rathod
Rami Z Morsi
Christopher J Standaert
Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials
BMJ Open
title Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials
title_full Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials
title_fullStr Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials
title_full_unstemmed Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials
title_short Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials
title_sort interventional treatments for chronic axial or radicular non cancer spinal pain a protocol for a systematic review and network meta analysis of randomised trials
url https://bmjopen.bmj.com/content/11/7/e046025.full
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