title: Management of chronic neuropathic pain: a protocol for a multiple treatment comparison meta-analysis of randomised controlled trials.
abstract: BACKGROUND
  Chronic neuropathic pain is associated with reduced health-related quality of life and substantial socioeconomic costs. Current research addressing management of chronic neuropathic pain is limited. No review has evaluated all interventional studies for chronic neuropathic pain, which limits attempts to make inferences regarding the relative effectiveness of treatments.
  
  
  METHODS
  We will conduct a systematic review of all randomised controlled trials evaluating therapies for chronic neuropathic pain. We will identify eligible trials, in any language, by a systematic search of CINAHL, EMBASE, MEDLINE, AMED, HealthSTAR, DARE, PsychINFO and the Cochrane Central Registry of Controlled Trials. Eligible trials will be: (1) enrol patients presenting with chronic neuropathic pain, and (2) randomise patients to alternative interventions (pharmacological or non-pharmacological) or an intervention and a control arm. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible trials and extract information from eligible trials. We will use a modified Cochrane instrument to evaluate risk of bias of eligible studies, recommendations from the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) to inform the outcomes we will collect, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate our confidence in treatment effects. When possible, we will conduct: (1) in direct comparisons, a random-effects meta-analysis to establish the effect of reported therapies on patient-important outcomes; and (2) a multiple treatment comparison meta-analysis within a Bayesian framework to assess the relative effects of treatments. We will define a priori hypotheses to explain heterogeneity between studies, and conduct meta-regression and subgroup analyses consistent with the current best practices.
  
  
  BACKGROUND
  We do not require ethics approval for our proposed review. We will disseminate our findings through peer-reviewed publications and conference presentations.
  
  
  BACKGROUND
  PROSPERO (CRD42014009212).
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Outcomes Research Consortium, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Sohail M
authors.initials: SM
authors.lastname: Mulla
authors.affiliation: Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.
authors.forename: D Norman
authors.initials: DN
authors.lastname: Buckley
authors.affiliation: Departments of Clinical Neurological Sciences and Oncology, Western University, London, Ontario, Canada.
authors.forename: Dwight E
authors.initials: DE
authors.lastname: Moulin
authors.affiliation: Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Couban
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Zain
authors.initials: Z
authors.lastname: Izhar
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Arnav
authors.initials: A
authors.lastname: Agarwal
authors.affiliation: Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Akbar
authors.initials: A
authors.lastname: Panju
authors.affiliation: Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Sun Makosso
authors.initials: SM
authors.lastname: Kallyth
authors.affiliation: Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Alparslan
authors.initials: A
authors.lastname: Turan
authors.affiliation: Knowledge and Evaluation Research Unit, Divisions of Endocrinology and Diabetes, and Health Care & Policy Research, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.affiliation: Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Sessler
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Lehana
authors.initials: L
authors.lastname: Thabane
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Gordon H
authors.initials: GH
authors.lastname: Guyatt
authors.affiliation: Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Busse
mesh_terms: D059350:Chronic Pain / Q000628:therapy*; D006801:Humans; D009437:Neuralgia / Q000628:therapy*; D059408:Pain Management; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D015201:Meta-Analysis as Topic
keywords: EPIDEMIOLOGY; STATISTICS & RESEARCH METHODS