Cordotomy in mesothelioma-related pain: a systematic review

Cordotomy in mesotheliomarelated pain: a systematic review CASP Analysis Emma Lowe

Did the review address a clearly focused question?

Did the review address a clearly focused question? • Clearly set out PICO • P – Patients with mesothelioma where the intension was to perform cordotomy • I – Cordotomy • C – Treatment for pain using other modalities • O – Effectiveness of pain relief and side effects

Did the authors look for the appropriate sort of papers?

Did the authors look for the appropriate sort of papers? • • • •

Excluded reviews and single case reports 9 papers included All included papers all seem relevant All studies were case series – lowest form of evidence – reflects the poor quality of evidence available

Do you think the important, relevant studies were included?

Do you think the important, relevant studies were included? • Search strategy designed for sensitivity not specificity. • Basically searched for every trial about cordotomy and then manually reviewed (2385 to 9!) • 14 databases • Reviewed reference lists from included studies and previous reviews • No limits on language, year of publication or publication status • Nil specific about contacting trialists although they did get some unpublished data (one was an author, one is a consultant in Warwick)

Did the review’s authors do enough to assess the quality of the included studies?

Did the review’s authors do enough to assess the quality of the included studies? • All had 1 or more limitation – loss to follow up of >10%, non-consecutive, reterospective, more than 20 years old,