title: [Cancer pain management: Systematic review and critical appraisal of clinical practice guidelines].
abstract: OBJECTIVE
  Although several clinical practice guidelines have been developed in the last decades, cancer pain management is still deficient. The purpose of this work was to carry out a comprehensive and systematic literature review of current clinical practice guidelines on cancer pain management, and critically appraise their methodology and content in order to evaluate their quality and validity to cope with this public health issue.
  
  
  METHODS
  A systematic review was performed in the main databases, using English, French and Spanish as languages, from 2008 to 2013. Reporting and methodological quality was rated with the Appraisal of Guidelines, Research and Evaluation II (AGREE-II) tool, including an inter-rater reliability analysis. Guideline recommendations were extracted and classified into several categories and levels of evidence, aiming to analyse guidelines variability and evidence-based content comprehensiveness.
  
  
  RESULTS
  Six guidelines were included. A wide variability was found in both reporting and methodological quality of guidelines, as well as in the content and the level of evidence of their recommendations. The Scottish Intercollegiate Guidelines Network guideline was the best rated using AGREE-II, while the Sociedad Española de Oncología Médica guideline was the worst rated. The Ministry of Health Malaysia guideline was the most comprehensive, and the Scottish Intercollegiate Guidelines Network guideline was the second one.
  
  
  CONCLUSIONS
  The current guidelines on cancer pain management have limited quality and content. We recommend Ministry of Health Malaysia and Scottish Intercollegiate Guidelines Network guidelines, whilst Sociedad Española de Oncología Médica guideline still needs to improve.
authors.affiliation: Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México. Electronic address: ismael.martinez@insp.mx.
authors.forename: I
authors.initials: I
authors.lastname: Martínez-Nicolás
authors.affiliation: Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: D
authors.initials: D
authors.lastname: Ángel-García
authors.affiliation: Centro de Investigación en Evaluación y Encuestas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: P J
authors.initials: PJ
authors.lastname: Saturno
authors.affiliation: Área de Gestión IV, Servicio Murciano de Salud, Hospital Comarcal de Caravaca, Caravaca, Murcia, España.
authors.forename: F
authors.initials: F
authors.lastname: López-Soriano
mesh_terms: D000072716:Cancer Pain / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D009369:Neoplasms; D059408:Pain Management; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results
keywords: Cancer; Gestión de Calidad; Guías de práctica clínica como asunto; Manejo del dolor; Neoplasias; Pain management; Practice guidelines as topic; Review; Revisión; Total quality management