{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:15:24Z","timestamp":1762506924784},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,10,3]],"date-time":"2016-10-03T00:00:00Z","timestamp":1475452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Department of Anesthesiology at Zealand University Hospital, K\u00f8ge, Denmark"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The majority of clinical trials regarding post\u2010operative pain treatment focuses on the average analgesic efficacy, rather than on efficacy in individual patients. It has been argued, that in acute pain trials, the underlying distributions are often skewed, which makes the average unfit as the only way to measure efficacy. Consequently, dichotomised, individual responder analyses using a predefined \u2018favourable\u2019 response, e.g. Visual Analogue Scale (<jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content>) pain scores \u2264 30, have recently been suggested as a more clinical relevant outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We re\u2010analysed data from 16 randomised controlled trials of post\u2010operative pain treatment and from meta\u2010analyses of a systematic review regarding hip arthroplasty. The predefined success criterion was that at least 80% of patients in active treatment groups should obtain <jats:styled-content style=\"fixed-case\">VAS<\/jats:styled-content> &lt; 30 at 6 and 24 h post\u2010operatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the analysis of data from the randomised controlled trials, we found that at 6 h post\u2010operatively, 50% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 31\u201369) of patients allocated to active treatment reached the success criterion for pain at rest and 14% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 5\u201334) for pain during mobilisation. At 24 h post\u2010operatively, 60% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 38\u201378) of patients allocated to active treatment reached the success criterion for pain at rest, and 15% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 5\u201336) for pain during mobilisation. Similar results were found for trials from the meta\u2010analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results indicate that for conventional, explanatory trials of post\u2010operative pain, individual patient's achievement of a favourable response to analgesic treatment is rather low. Future pragmatic clinical trials should focus on both average pain levels and individual responder analyses in order to promote effective pain treatment at the individually patient level.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12815","type":"journal-article","created":{"date-parts":[[2016,10,7]],"date-time":"2016-10-07T16:30:02Z","timestamp":1475857802000},"page":"83-90","source":"Crossref","is-referenced-by-count":12,"title":["Low degree of satisfactory individual pain relief in post\u2010operative pain trials"],"prefix":"10.1111","volume":"61","author":[{"given":"A.","family":"Geisler","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Zealand University Hospital K\u00f8ge Denmark"},{"name":"Department of Health Sciences Faculty of Medicine Lund University Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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