Page 124 WHO - Guidelines on the pharmacological treatment of persisting pain in children with medical illness

GRADE Table 15

Author: Wiffen PJ A1
Date: 26-05-2009
Question: Should transdermal fentanyl be used for cancer pain in children?
Setting: Not stated.
Bibliography: Zernikow B, Michel E, Anderson B. Transdermal fentanyl in childhood and adolescence:
a comprehensive literature review. The Journal of Pain, 2007, 8:187–207.

Summary of findings
Quality assessment A2
No. of patients Effect

No. of studies Design Limitations Inconsistency Indirectness Imprecision Other considerations Transdermal fentanyl Control Relative (95% CI) Absolute Quality

Satisfaction with therapy (patient or professional judgement) A3
11 Obser- Very Serious b Serious c No Reporting 311 Not Not Not LOW
vational seri- serious bias d reported pooled pooled
studies ous a impre-
cision
CI, confidence interval. A4 A4
a All observational studies: 6 studies were of 10 patients or less; 1 study was of 199 patients.
b Different conditions, different doses, some acute, and different populations.
c Not all cancer pain, some post-operative pain.
d Observational studies are difficult to identify by current search techniques.

A5

A6

A7

121 <