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Fan M, Liu A, Lu T, Zhou X, Tian C, Liu B, Xie Q, Cai J, Yin L, Ge L, Wu D. Quality appraisal of clinical practice guidelines addressing massage interventions using the AGREE II instrument. Syst Rev 2024; 13:83. [PMID: 38459534 PMCID: PMC10921609 DOI: 10.1186/s13643-024-02503-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 02/23/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVE The purpose of this study was to systematically evaluate the methodological quality of massage-related clinical practice guidelines (CPGs)/consensus on massage using the Appraisal of Guidelines Research and Evaluation (AGREE II) instrument and to summarize the current status of recommendations in the CPGs. METHODS The Chinese National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database (VIP), China Biology Medicine disc (CBM), PubMed, Embase, and guideline websites (such as the Chinese Medical Ace Base, the China Association of Chinese Medicine, the World Health Organization, Guideline International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network) were searched from inception to October 31, 2022. In addition, the reference lists of relevant studies were reviewed to identify domestic and overseas massage CPGs/consensus. The search terms adopted a combination of subject words and free words, mainly including traditional Chinese medicine, complementary therapies, Tuina, massage, manipulation, chiropractic/osteopathic, spinal, acupressure, guideline, and consensus. Two researchers independently completed the eligible records and extracted the data. Before the formal research, calibrations were performed twice on AGREE II, and all reviewers completed the pilot test three times until they understood and reached an agreement on the assessment items. Three researchers appraised the methodological quality of the included guidelines using the AGREE II instrument and calculated the overall intraclass correlation coefficient (ICC) of agreement. RESULTS The evaluation results showed that among the 49 eligible CPGs/consensus, 4 (8.2%) CPGs/consensus were considered "recommended", 15 (30.6%) CPGs/consensus were considered "recommended with modifications", and 30 (61.2%) CPGs/consensus were considered "not recommended", while the consensus was considered "not recommended". Generally, the scores in the six domains of the guidelines were all higher than the consensus. Evaluation results for the overall quality of 36 CPGs showed that 4 (11%) were "good quality", 15 (42%) were "sufficient quality" and 17 (47%) were "lower quality". The AGREE II quality scores of domains ranged from 0.30 to 0.75 ([ICC = 0.993, 95% CI (0.992, 0.995)]). The domain of scope and purpose (domain 1), with a median score of 0.75 (0.52~0.91), performed best in the guidelines with AGREE II, and stakeholder involvement (domain 2) [median 0.39 (0.31~0.56)] and application (domain 5) [median 0.30 (0.17~0.47] obtained lower scores. The consensus score of domain 1 was better at 26.0 (21.6~44.8), followed by rigor of development (domain 3) with a score of 18.0 (10.0~28.9). A total of 119 massage-related recommendations were extracted from 49 guidelines/consensuses, including "in favor" (102, 85.7%), "against" (9, 7.6%), and "did not make recommendations" (8, 6.7%). CONCLUSION The overall quality of the included guidelines was low, and most of the guidelines were not "recommended". In future guideline updates, the existing evidence should be used, the professional composition of members of the expert group should be enriched, and patients' values and preferences should be fully considered. It is necessary to clearly propose recognizable recommendations and strengthen the rigor and standardization of guideline formulation. Thus, clear standard guidelines can be formulated to better guide clinical practice.
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Affiliation(s)
- Mingyue Fan
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Aolin Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Taoying Lu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Xiaowen Zhou
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Chen Tian
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Bingqing Liu
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
| | - Qianwen Xie
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Jianxiong Cai
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
| | - Lingjia Yin
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China
- Karolinska Institutet, Stockholm, Sweden
| | - Long Ge
- Department of Social Science and Health Management, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
- Key Laboratory of Evidence-Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, People's Republic of China
| | - Darong Wu
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
- Outcome assessment research team in Chinese medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
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Top APC, de Leeuw TG, Bramer WM, de Mol BCM, Huygen FJPM, Dirckx M. How Do We Treat Children with Anterior Cutaneous Nerve Entrapment Syndrome and Is the Biopsychosocial Model Also Being Applied? A Scoping Review. Pain Res Manag 2024; 2024:6813025. [PMID: 38318481 PMCID: PMC10843870 DOI: 10.1155/2024/6813025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/12/2024] [Accepted: 01/13/2024] [Indexed: 02/07/2024]
Abstract
Background Evidence-based guidelines for managing anterior cutaneous nerve entrapment syndrome (ACNES) in children are absent. The primary aim of this review was to scrutinize the evidence supporting currently used treatment interventions. In accordance with the World Health Organization (WHO) guidelines for managing chronic pain in children, these patients and their families and caregivers should be treated within the context of the biopsychosocial model; pain should not be treated purely as a biomedical problem. Therefore, our second aim was to evaluate whether these interventions are applied within the context of the biopsychosocial model, utilizing an inter- or multidisciplinary approach. Materials and Methods A scoping review of the literature was conducted to explore treatment strategies for ACNES in children. To ensure a comprehensive overview of published literature on this topic, the search was not restricted based on study type. Two reviewers independently assessed titles and abstracts. After excluding records unrelated to children, full texts were screened for inclusion. Any discrepancies in judgement were resolved through discussion with a third reviewer. Results Out of 35 relevant titles, 22 were included in this review. Only 4 articles provided information on long-term outcomes. The overall quality of the review was deemed low. The majority of reports did not address treatment or education within the psychological and social domains. A structural qualitative analysis was not feasible due to the substantial heterogeneity of the data. Conclusion The evidence supporting current treatment strategies in children with ACNES is of low quality. More research is needed to establish an evidence-based treatment algorithm for patients with this challenging pain problem. In line with the WHO recommendation, greater emphasis should be placed on a biopsychosocial approach. The ultimate goal should be the development of a generic treatment algorithm outlining an approach to ACNES applicable to all professionals involved.
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Affiliation(s)
- Anke P. C. Top
- Department of Anesthesiology, Amsterdam UMC, University Hospital Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, Netherlands
| | - Thomas G. de Leeuw
- Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
- Center for Pain Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
| | - Wichor M. Bramer
- Medical Library, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
| | - Bernadette C. M. de Mol
- Department of Anesthesiology, Erasmus MC-Sophia Children's Hospital, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
- Center for Pain Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
| | - Frank J. P. M. Huygen
- Center for Pain Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
| | - Maaike Dirckx
- Center for Pain Medicine, Erasmus MC, Erasmus University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
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Kamal HY, Morneault-Gill K, Chadwick CB. What is new with irritable bowel syndrome. Curr Opin Pediatr 2023; 35:574-578. [PMID: 37540073 DOI: 10.1097/mop.0000000000001280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
PURPOSE OF REVIEW This review aims to summarize the most up-to-date criteria for diagnosis of pediatric irritable bowel syndrome (IBS) and treatment options. It also explores recent research that has been performed evaluating risk factors, pathophysiology, and treatment designed to improve quality of life for those who suffer from IBS. IBS is a common disorder in pediatrics and one of the most common causes of abdominal pain for children; thus, it can be quite debilitating for individuals to achieve a satisfactory quality of life on a routine basis. Reliable, available treatment is needed but can be challenging to find, given the variety of symptoms and triggers involved and lack of a clear understanding of how IBS develops. RECENT FINDINGS There are multiple pharmacologic and nonpharmacologic treatment options being explored and studied globally but further, larger, and well controlled studies are needed to confirm these outcomes. SUMMARY Because pediatric IBS is one of the most common functional disorders associated with abdominal pain and can be brought on by multiple factors, management often involves addressing these individual triggers with a multifaceted treatment plan, which could include dietary changes, probiotics, medication, or psychotherapy and should be tailored to each affected individual.
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Affiliation(s)
- Hebat Y Kamal
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, University of Florida College of Medicine, Gainesville, Florida, USA
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Anheyer M, Höfel L. [Complementary procedures for chronic pain disorders in childhood and adolescence]. Schmerz 2023; 37:324-329. [PMID: 36920553 DOI: 10.1007/s00482-023-00699-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/22/2023] [Accepted: 01/24/2023] [Indexed: 03/16/2023]
Abstract
Pain that persists or recurs over a period of at least 3 months in childhood and adolescence is referred to as chronic pain. The primary localization of pain changes according to age: abdominal pain is more common at a younger age, headache is more common in adolescents and later back pain as well as muscle and joint pain. In the multimodal and interdisciplinary treatment of chronic pain, complementary procedures can expand the treatment spectrum. This article provides an overview of the existing evidence that for childhood and adolescence can at best be evaluated as readily understandable. In addition, the experiences of two children's hospitals show that complementary medicine can be used as a low-threshold and easily implemented therapy.
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Affiliation(s)
- Melanie Anheyer
- Klinik für Kinder- und Jugendmedizin, Elisabeth-Krankenhaus Essen, Klara-Kopp-Weg 1, 45138, Essen, Deutschland.
| | - Lea Höfel
- Zentrum für Schmerztherapie junger Menschen, Kinderklinik Garmisch-Partenkirchen, Gehfeldstraße 24, 82467, Garmisch-Partenkirchen, Deutschland
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Chen JY, Chen SN, Lee CH, Huang YJ. A systematic review and meta-analysis of randomized control trials: efficacy of cognitive behavioral therapies for the management of functional and recurrent abdominal pain disorders in children and adolescents. Cogn Behav Ther 2023; 52:438-459. [PMID: 37102319 DOI: 10.1080/16506073.2023.2200562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 03/30/2023] [Indexed: 04/28/2023]
Abstract
Cognitive behavioral therapy (CBT) is effective for pain relief in children and adolescents with functional abdominal pain disorders (FAPDs). However, few studies have focused on the FAPDs specifically and the medium-term or long-term results of CBT. In this meta-analysis, we investigated the efficacy of CBT in pediatric FAPDs and unclassified chronic or recurrent abdominal pain (CAP and RAP, respectively). We searched the PubMed, Embase, and Cochrane Library databases for related randomized controlled trials until August 2021. Eventually, 10 trials with 872 participants were included. The methodological quality of the studies was assessed, and data on two primary and four secondary outcomes of interest were extracted. We used the standardized mean difference (SMD) to measure the same outcome, and precisions of effect sizes were reported as 95% confidence intervals (CIs). We found that CBT had significantly positive effects on reducing pain intensity immediately (SMD: -0.54 [CI: -0.9, -0.19], p = 0.003), 3 months after the intervention (SMD: -0.55; [CI: -1.01, -0.1], p = 0.02) and 12 months after the intervention (SMD: -0.32; [CI: -0.56, -0.08], p = 0.008). CBT also reduced the severity of gastrointestinal symptoms, depression, and solicitousness, improved the quality of life and decreased the total social cost. Future studies should consider uniform interventions in the control group and comparing different CBT delivery methods.
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Affiliation(s)
- Jia-Yi Chen
- Department of Education Center, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Sheng-Ni Chen
- Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan
| | - Che-Hsiung Lee
- Department of Plastic and Reconstructive Surgery, New Taipei Municipal TuCheng Hospital, New Taipei City, Taiwan
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Yu-Jui Huang
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
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Bjerre-Nielsen E, Kallesøe KH, Nielsen ES, Gehrt TB, Frostholm L, Rask CU. A New Experimental Design to Examine Cognitive Biases for Gastrointestinal Related Stimuli in Children and Adolescents. Children (Basel) 2023; 10:1327. [PMID: 37628326 PMCID: PMC10453649 DOI: 10.3390/children10081327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023]
Abstract
Cognitive biases toward disorder-specific stimuli are suggested as crucial to the development and maintenance of symptoms in adults with functional gastrointestinal disorders (FGID). Functional abdominal pain disorders (FAPD), a subtype of FGID, are common in children and adolescents, but the influence of cognitive biases is sparsely examined. This study aimed to (1) develop a new experimental design for assessing cognitive biases toward gastrointestinal stimuli in children and adolescents (aged 8 to 17 years) and (2) derive comparative data on bias toward gastrointestinal stimuli using a healthy "normative" sample. The online experimental design-BY-GIS (Bias in Youth toward GastroIntestinal-related Stimuli)-includes a word task and a picture task. Stimuli in both tasks are related to general and gastrointestinal symptoms, and the design includes three phases: (1) encoding, (2) free recall, and (3) recognition. Data were collected between April 2022 and April 2023 from 96 healthy participants (Mage = 12.32, 47.92% female). Adolescents were significantly better at recalling words than children (p = 0.03), whereas there were no significant gender or age differences with regard to recalling pictures (p > 0.05). Across age and gender, participants performed above chance level in the recognition phases of both tasks. The results support that the design is suitable within the age span.
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Affiliation(s)
- Ellen Bjerre-Nielsen
- Research Unit, Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Karen Hansen Kallesøe
- Research Unit, Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus, Denmark
| | - Eva Skovslund Nielsen
- Research Unit, Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Tine Bennedsen Gehrt
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
- Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Aarhus BSS, Bartholins Allé 11, 8200 Aarhus, Denmark
- Department of Research and Development, Prehospital Emergency Medical Services, Central Denmark Region, Brendstrupgårdsvej 7, 8200 Aarhus, Denmark
| | - Lisbeth Frostholm
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
- The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 11, 8200 Aarhus, Denmark
| | - Charlotte Ulrikka Rask
- Research Unit, Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark
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Puckett-Perez S, Gresl B. Psychological treatment for pediatric functional abdominal pain disorders. Curr Opin Pediatr 2022; 34:516-520. [PMID: 35993286 DOI: 10.1097/mop.0000000000001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss up-to-date psychological treatment strategies for functional abdominal pain disorders (FAPDs) with practical implications for primary care providers who are the "front line" of treatment for pediatric FAPD. RECENT FINDINGS Positive diagnosis, pain education, and access to multidisciplinary care improve outcomes for FAPD patients. Cognitive behavioral therapy (CBT) and hypnosis continue to have the strongest evidence in psychological treatments, but educational interventions and other nonpharmacological approaches show promise as well. There are innovative programs that combine these tools into group or internet-based treatments to expand access to care. Additionally, nonpharmacological tools, including neurostimulation and virtual reality programs, are increasing in popularity. SUMMARY FAPD is prevalent across pediatric practices, yet there is no standard medical or dietary approach, and there are many barriers to diagnosis and treatment. It is important for patients to have positive encounters around diagnosis and education, access to multidisciplinary care, and integrated psychological support. Consistently, studies show that psychology continues to be a vital component of care. This review discusses supported uses of psychology, innovative programming for increasing access to care, and how primary care providers can incorporate lessons learned from psychology in FAPD care. VIDEO ABSTRACT http://links.lww.com/MOP/A67 .
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Affiliation(s)
- Stevie Puckett-Perez
- Department of Gastroenterology, Hepatology, and Nutrition, Children's Medical Center Dallas, Children's Health, Department of Psychiatry, University of Texas Southwestern (UTSW), Dallas, Texas, USA
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