Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC
Here we provide the updated version of the guidelines of the European Association for Palliative Care (EAPC) on the use of opioids for the treatment of cancer pain. The update was undertaken by the European Palliative Care Research Collaborative. Previous EAPC guidelines were reviewed and compared with other currently available guidelines, and consensus recommendations were created by formal international expert panel. The content of the guidelines was defined according to several topics, each of which was assigned to collaborators who developed systematic literature reviews with a common methodology. The recommendations were developed by a writing committee that combined the evidence deriv…
Reply to the letter to the editor ‘How much evidence isn't in evidence-based guidelines?’ by Johnson et al.
ABSTRACT ESMO produces pan-European, multidisciplinary, peer-reviewed and updatable guidelines with global impact on current clinical practice, with the intention of providing the practising health professional in cancer care with an easy to use, evidence-based tool for optimal patient management. Levels of evidence and strength of recommendation metrics are provided. In the Dyspnoea ESMO CPG, we strove to fulfill these targets, though we accept any productive criticism that will contribute to the improvement of the product.
Biases in study design, implementation, and data analysis that distort the appraisal of clinical benefit and ESMO-Magnitude of Clinical Benefit Scale (ESMO-MCBS) scoring
BACKGROUND: The European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) is a validated, widely used tool developed to score the clinical benefit from cancer medicines reported in clinical trials. ESMO-MCBS scores assume valid research methodologies and quality trial implementation. Studies incorporating flawed design, implementation, or data analysis may generate outcomes that exaggerate true benefit and are not generalisable. Failure to either indicate or penalise studies with bias undermines the intention and diminishes the integrity of ESMO-MCBS scores. This review aimed to evaluate the adequacy of the ESMO-MCBS to address bias generated by flawed design, im…