tailieunhanh - Control of pain in adults with cancer

When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the original tumor. For example, if ovarian cancer spreads to the liver, the cancer cells in the liver are actually ovarian cancer cells. The disease is metastatic ovarian cancer, not liver cancer. For that reason, it is treated as ovarian cancer, not liver cancer. Doctors call the new tumor “distant” or metastatic disease. | e SIGN Scottish Intercollegiate Guidelines Network NHS Quality Improvement Scotland 106 Control of pain in adults with cancer A national clinical guideline November 2008 KEY TO EVIDENCE STATEMENTS AND GRADES OF RECOMMENDATIONS LEVELS OF EVIDENCE 1 High quality meta-analyses systematic reviews of RCTs or RCTs with a very low risk of bias 1 Well conducted meta-analyses systematic reviews or RCTs with a low risk of bias 1- Meta-analyses systematic reviews or RCTs with a high risk of bias 2 High quality systematic reviews of case control or cohort studies High quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal 2 Well conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal 2 - Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal 3 Non-analytic studies eg case reports case series 4 Expert opinion GRADES OF RECOMMENDATION Note The grade of recommendation relates to the strength of the evidence on which the recommendation is based. It does not reflect the clinical importance of the recommendation. At least one meta-analysis systematic review or RCT rated as 1 and directly applicable to the target population or A body of evidence consisting principally of studies rated as 1 directly applicable to the target population and demonstrating overall consistency of results A body of evidence including studies rated as 2 directly applicable to the target population and demonstrating overall consistency of results or Extrapolated evidence from studies rated as 1 or 1 A body of evidence including studies rated as 2 directly applicable to the target population and demonstrating overall consistency of results or Extrapolated evidence from studies rated as 2 Evidence level 3 or 4 or Extrapolated evidence from studies rated as 2 A B C D GOOD .