TY - JOUR
T1 - An analysis of harms reporting in systematic reviews regarding ketorolac for management of perioperative pain
AU - Modi, Jay
AU - Magee, Trevor
AU - Rucker, Brayden
AU - Flores, Holly
AU - Wise, Audrey
AU - Kee, Micah
AU - Garrett, Morgan
AU - Roberts, Will
AU - Vassar, Matt
N1 - Funding Information:
MV reports receipt of funding from the National Institute on Drug Abuse (grant #: 1R15DA049201-01), the National Institute on Alcohol Abuse and Alcoholism (grant #: 1T35AA028204-01), the US Office of Research Integrity, Oklahoma Center for Advancement of Science and Technology, and internal grants from Oklahoma State University (grant #: 4 ORIIR190056-01-01) Center for Health Sciences – all outside of the present work. All other authors have nothing to report.
Publisher Copyright:
© 2022 British Journal of Anaesthesia
PY - 2022/11
Y1 - 2022/11
N2 - Background: Owing to the frequent perioperative use of ketorolac tromethamine and its ability to minimise postoperative opioid requirements, it is important to continually reassess harms associated with its use. Our primary objective was to investigate the extent of harms reporting in systematic reviews (SRs) on ketorolac for perioperative pain. Methods: In May 2022, we conducted a search of major databases, MEDLINE (PubMed and Ovid), Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews to identify eligible SRs on ketorolac for perioperative pain. Screening and data extraction were performed in masked, duplicate fashion. A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) was used to appraise the methodological quality of included SRs. Corrected covered area (CCA) was calculated to determine overlap of primary studies between SR dyads. Results: A total of 28 SRs evaluating 630 primary studies met the inclusion criteria. Seven SRs (7/28, 25%) reported no harms and 17 SRs (17/28, 60.7%) reported ≤50% of harms items. A significant association was found between completeness of harms reporting and whether harms were specified as a primary outcome (P<0.001). No other associations were statistically significant. Regarding methodological quality, 22 SRs were appraised as ‘critically low’ (22/28, 78.6%), 5 as ‘low’ (5/28, 17.9%), and 1 as ‘high’ (1/28, 3.6%). One SR dyad had a CCA >50% but neither reported harms. Conclusions: The extent of harms reporting in systematic reviews was inadequate. Given the importance that systematic reviews have on guiding perioperative decision-making, it is essential to improve the completeness of harms reporting.
AB - Background: Owing to the frequent perioperative use of ketorolac tromethamine and its ability to minimise postoperative opioid requirements, it is important to continually reassess harms associated with its use. Our primary objective was to investigate the extent of harms reporting in systematic reviews (SRs) on ketorolac for perioperative pain. Methods: In May 2022, we conducted a search of major databases, MEDLINE (PubMed and Ovid), Embase, Epistemonikos, and the Cochrane Database of Systematic Reviews to identify eligible SRs on ketorolac for perioperative pain. Screening and data extraction were performed in masked, duplicate fashion. A MeaSurement Tool to Assess systematic Reviews-2 (AMSTAR-2) was used to appraise the methodological quality of included SRs. Corrected covered area (CCA) was calculated to determine overlap of primary studies between SR dyads. Results: A total of 28 SRs evaluating 630 primary studies met the inclusion criteria. Seven SRs (7/28, 25%) reported no harms and 17 SRs (17/28, 60.7%) reported ≤50% of harms items. A significant association was found between completeness of harms reporting and whether harms were specified as a primary outcome (P<0.001). No other associations were statistically significant. Regarding methodological quality, 22 SRs were appraised as ‘critically low’ (22/28, 78.6%), 5 as ‘low’ (5/28, 17.9%), and 1 as ‘high’ (1/28, 3.6%). One SR dyad had a CCA >50% but neither reported harms. Conclusions: The extent of harms reporting in systematic reviews was inadequate. Given the importance that systematic reviews have on guiding perioperative decision-making, it is essential to improve the completeness of harms reporting.
KW - cross-sectional analysis
KW - harms reporting
KW - ketorolac adverse effects
KW - ketorolac postoperative
KW - perioperative care
KW - perioperative ketorolac
KW - perioperative pain
KW - systematic reviews
UR - http://www.scopus.com/inward/record.url?scp=85139058197&partnerID=8YFLogxK
U2 - 10.1016/j.bja.2022.08.007
DO - 10.1016/j.bja.2022.08.007
M3 - Article
C2 - 36175184
AN - SCOPUS:85139058197
SN - 0007-0912
VL - 129
SP - 767
EP - 775
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
IS - 5
ER -