The WHO analgesic ladder for cancer pain management: stepping up the quality of its evaluation

Article Abstract:

It may be time to do controlled trials to see if the analgesic ladder proposed by the World Health Organization (WHO) is effective in treating cancer pain. The analgesic ladder is a set of simple guidelines that focuses on cheap, effective analgesics. It was published by WHO in 1986 and more than 250,000 copies have been distributed worldwide. However, a review of the literature revealed that there have only been eight studies to rigorously assess whether the ladder is effective. None of the studies included a control group and half followed fewer than 100 patients. Overall, adequate pain relief was achieved in 69% to 100% of the patients in the studies.

Management, Social policy, Cancer pain, World Health Organization

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Rating health information on the Internet: navigating to knowledge or to Babel?

Article Abstract:

It may be very difficult to develop methods of rating health information sources on the Internet. Many physicians believe some types of information on the Internet may be misleading or even harmful. Researchers used various Internet search services to locate 47 different rating instruments. Only 14 described the criteria used to rate different information sources and only 5 provided instructions for using the rating instrument.

Evaluation, World Wide Web, Health education

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Development and Aftercare of Clinical Guidelines: The Balance Between Rigor and Pragmatism

Article Abstract:

The trade-off between creating a useful practice guideline that will not be obsolete in a few years is discussed. Practice guidelines are documents that recommend treatments for specific diseases based on scientific evidence. However, it takes time to review and synthesize the literature on a particular topic. By the time it is published and widely adopted, it could be outdated by new evidence.

Editorial, Analysis, Practice guidelines (Medicine), Evidence-based medicine

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