title: Efficacy of treatments and pain management for trapeziometacarpal (thumb base) osteoarthritis: protocol for a systematic review.
abstract: BACKGROUND
  The thumb is essential for daily activities. Unfortunately, this digit is commonly affected by trapeziometacarpal osteoarthritis (TMO), handicapping a large number of individuals. TMO constitutes an increasing human and economic burden for our society whose population is ageing. Limited access to adequate treatment is among the most important obstacles to optimal TMO management. Poor understanding of TMO characteristics, lack of knowledge about evidence-based treatments, simplistic pain management plans based solely on the patient's physical condition, absence of interprofessional communication and lack of multidisciplinary treatment guidelines contribute to inadequate TMO management. On the long term, our research project aims at improving the quality of care and services offered to patients with TMO by developing a patient-centred, evidence-based multidisciplinary management clinical pathway coordinated across the healthcare system. This proposed systematic review is a prerequisite to ensuring evidence-based practices and aims to document the efficacy of all the existing modalities for TMO management.
  
  
  METHODS
  The protocol of the systematic review is registered with PROSPERO and will be conducted using the guidelines Cochrane Handbook for Systematic Reviews of Interventions. We will identify studies in English and French concerning TMO treatments through searches in Cochrane Central, EMBASE, MEDLINE, PsychINFO, CINHAL, PubMed, OT Seekers, PEDRO and the grey literature. 2 reviewers will independently screen study eligibility, extract data and appraise studies using published assessment tools. Meta-analyses will be undertaken where feasible; otherwise, narrative syntheses will be carried out. The robustness of evidence will be assessed using the GRADE system.
  
  
  BACKGROUND
  Ethics approval is not required for this study. A comprehensive knowledge exchange and transfer plan incorporating effective strategies will be used to disseminate the findings of this review and utilise them to optimise TMO management.
  
  
  BACKGROUND
  PROSPERO CRD42015015623.
authors.affiliation: CHUM Research Center, Montreal, Quebec, Canada Faculty of Medicine, School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada Hand Clinic, CHUM, Montreal, Quebec, Canada.
authors.forename: Tokiko
authors.identifier: http://orcid.org/0000-0002-9514-0676
authors.initials: T
authors.lastname: Hamasaki
authors.affiliation: CHUM Research Center, Montreal, Quebec, Canada Faculty of Pharmacy, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Lyne
authors.initials: L
authors.lastname: Lalonde
authors.affiliation: Hand Clinic, CHUM, Montreal, Quebec, Canada Faculty of Medicine, Department of Surgery, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Patrick
authors.identifier: http://orcid.org/0000-0001-5868-0203
authors.initials: P
authors.lastname: Harris
authors.affiliation: CHUM Research Center, Montreal, Quebec, Canada Faculty of Medicine, Department of Radiology, Radio-Oncology and Nuclear Medicine, Université de Montréal, Montreal, Quebec, Canada Department of Radiology, CHUM, Montreal, Quebec, Canada.
authors.forename: Nathalie J
authors.identifier: http://orcid.org/0000-0003-3710-9280
authors.initials: NJ
authors.lastname: Bureau
authors.affiliation: Faculty of Medicine and Health Sciences, School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Quebec, Canada Charles-LeMoyne Hospital Research Center, Longueuil, Quebec, Canada.
authors.forename: Nathaly
authors.initials: N
authors.lastname: Gaudreault
authors.affiliation: CHUM Library, Montreal, Quebec, Canada.
authors.forename: Daniela
authors.identifier: http://orcid.org/0000-0002-7210-5296
authors.initials: D
authors.lastname: Ziegler
authors.affiliation: CHUM Research Center, Montreal, Quebec, Canada Faculty of Medicine, Department of Anesthesiology, Universite de Montreal, Montreal, Quebec, Canada.
authors.forename: Manon
authors.initials: M
authors.lastname: Choinière
mesh_terms: D018771:Arthralgia / Q000209:etiology / Q000628:therapy*; D002985:Clinical Protocols; D006801:Humans; D008662:Metacarpophalangeal Joint; D010003:Osteoarthritis / Q000150:complications / Q000628:therapy*; D059408:Pain Management / Q000379:methods*; D000078202:Systematic Reviews as Topic; D013933:Thumb
keywords: PAIN MANAGEMENT; RHEUMATOLOGY