Annals of Emergency Medicine
Volume 36, Issue 3 , Pages 247-252 , September 2000

Ten Challenges at the Intersection of Clinical Research, Evidence-Based Medicine, and Pain Relief

  • Alejandro R. Jadad, MD, DPhil

      Affiliations

    • Program in Evidence-based Care, Cancer Care Ontario; Health Information Research Unit, McMaster Evidence-based Practice Center, Canadian Cochrane Network and Centre, and Departments of Clinical Epidemiology and Biostatistics, and Anaesthesia, McMaster University, Hamilton, Ontario, Canada
    • ,
  • M.Soledad Cepeda, MD

      Affiliations

    • Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA.

Received 31 March 2000 ,Accepted 4 April 2000.

References 

  1. McQuay HJ, Moore RA. An Evidence-Based Resource for Pain Relief. Oxford, NY: Oxford University Press; 1998;
  2. Jadad AR, Carroll D, Moore A, et al.  Developing a database of published reports of randomised clinical trials in pain research. Pain. 1996;66:239–246
  3. Waeckerle JF, Cordell WH, Wyer P, et al.  Evidence-based emergency medicine: integrating research into practice. Ann Emerg Med. 1997;30:626–628
  4. Jadad A. Randomised Controlled Trials: A User’s Guide. London: BMJ Books. http://www.bmjpg.com/rct1998; Available at
  5. Jadad AR, Haynes RB. The Cochrane Collaboration—advances and challenges in improving evidence-based decision making. Med Decis Making. 1998;18:2–9
  6. Naylor CD. Grey zones of clinical practice: some limits to evidence-based medicine. Lancet. 1995;345:840–842
  7. Rowe BH, Alderson P. The Cochrane Library: a resource for clinical problem solving in emergency medicine. Ann Emerg Med. 1999;34:86–90
  8. Dickersin K. How important is publication bias? A synthesis of available data. AIDS Educ Prev. 1997;9:15–21
  9. Jadad AR, Rennie D. The randomized controlled trial gets a middle-aged checkup. JAMA. 1998;279:319–320 [editorial]
  10. Bero LA, Rennie D. Influences on the quality of published drug studies. Int J Technol Assess Health Care. 1996;12:209–237
  11. Jadad A, Whelan T, Rayno L, et al.  “A team approach to pain relief”: a guide developed with patients and family members. Support Care Cancer. 1996;3:245; [abstract]
  12. Bero LA, Jadad AR. How consumers and policymakers can use systematic reviews for decision making. Ann Intern Med. 1997;127:37–42
  13. Vanchieri C. Cancer researcher’s odyssey benefits many patients. J Natl Cancer Inst. 1998;90:184–186 [news]
  14. Moore RA, Gavaghan D, Tramer MR, et al.  Size is everything—large amounts of information are needed to overcome random effects in estimating direction and magnitude of treatment effects. Pain. 1998;78:209–216
  15. Jadad AR, Moore RA, Carroll D, et al.  Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996;17:1–12
  16. Begg C, Cho M, Eastwood S, et al.  Improving the quality of reporting of randomized controlled trials. The CONSORT statement. JAMA. 1996;276:637–639
  17. CONSORT Web site. Available at: http://www.consort-statement.org .
  18. Moher D. CONSORT: an evolving tool to help improve the quality of reports of randomized controlled trials. Consolidated Standards of Reporting Trials. JAMA. 1998;279:1489–1491
  19. Moher D, Cook DJ, Eastwood S, et al.  Improving the quality of reports of meta-analyses of randomized controlled trials: the QUOROM statement. Lancet. 1999;354:1896–1900
  20. Cordell WH. Number needed to treat (NNT). Ann Emerg Med. 1999;33:433–436
  21. Moore A, McQuay H, Gavaghan D. Deriving dichotomous outcome measures from continuous data in randomised controlled trials of analgesics. Pain. 1996;66:229–237
  22. Haynes RB. Loose connections between peer-reviewed clinical journals and clinical practice. Ann Intern Med. 1990;113:724–728
  23. Locke D. Voices of science. Am Scholar. 1998;67:103–114
  24. Enkin MW, Jadad AR. Using anecdotal information in evidence-based health care: heresy or necessity?. Ann Oncol. 1998;9:963–966
  25. Jadad AR, Haynes RB, Hunt D, et al.  The Internet and evidence-based decision-making: a needed synergy for efficient knowledge management in health care. CMAJ. 2000;162:362–365 Available at http://www.cma.ca/cmaj/vol-162/issue-3/0362.htm
  26. Ioannidis JP. Effect of the statistical significance of results on the time to completion and publication of randomized efficacy trials. JAMA. 1998;279:281–286
  27. Chalmers I. Underreporting research is scientific misconduct. JAMA. 1990;263:1405–1408
  28. Haynes RB, Jadad AR, Hunt DL. What’s up in medical informatics?. CMAJ. 1997;157:1718–1719
  29. Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association. JAMA. 1999;281:552–557
  30. Polanyi M. The Tacit Dimension. New York, NY: Doubleday; 1966;
  31. Jadad A, Enkin M. The new alchemy: transmuting information to knowledge in an electronic age. CMAJ. In press.
  32. Haynes RB, Sackett DL, Gray JM, et al.  Transferring evidence from research into practice: 1. The role of clinical care research evidence in clinical decisions. [editorial]. ACP J Club. 1996;125:A14–A16

☆ Editor’s Note: This article is based on an original article that appeared in the Summer 1999 edition of the newsletter Pain: Clinical Updates, published by the International Association for the Study of Pain (IASP). The original newsletter article has been modified and updated for Annals of Emergency Medicine. We gratefully acknowledge the support of Daniel B. Carr, MD, (newsletter editor), and Louisa E. Jones (IASP) for allowing us to use and revise the original article.

☆☆ Reprints not available from the authors. Address for correspondence: Alejandro R. Jadad, MD, DPhil, Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC-3H7, 1200 Main Street West, Hamilton, ON L8N 3Z5 Canada; 905-525-9140; E-mail: jadada@fhs.mcmaster.ca.

PII: S0196-0644(00)36113-3

doi: 10.1067/mem.2000.108095

Annals of Emergency Medicine
Volume 36, Issue 3 , Pages 247-252 , September 2000

Article Tools