Evidence map›Paper›PMID 39046534›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2024

Opioid analgesic dose and route conversion ratio studies: a scoping review to inform an eDelphi guideline.

Mellar P Davis, Andrew Davies, Mary Lynn McPherson, Akhila Reddy, Judith A Paice, Eric Roeland, Declan Walsh, Sebastiano Mercadante, Amy Case, Robert Arnold and 4 more

Erratum issuedAbstract readScoping Review
PubMed Publisher
In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Opioid conversion in adults with cancer: MASCC-ASCO-AAHPM-HPNA-NICSO guideline.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Guideline
  2. Opioid equipotency conversions for hospitalized infants: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2024
    Pooled it
  3. Trial
  4. Trial
  5. Article
  6. Review
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Mellar P DavisGeisinger Medical Center, Danville, PA, 17821, USA. mdavis2@geisinger.edu.
Andrew DaviesTrinity College Dublin, Dublin, Ireland.
Mary Lynn McPhersonUniversity of Maryland, Baltimore, ML, USA.
Akhila ReddyPalliative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Judith A PaiceFeinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Eric RoelandOregon Health and Science University, Knight Cancer Institute, Portland, OR, USA.
Declan WalshAtrium Health, Levine Cancer Center, Charlotte, NC, USA.
Sebastiano MercadanteLa Maddalena Cancer Center, Palermo, Italy.
Amy CaseRoswell Park Comprehensive Cancer Center, Rochester, NY, USA.
Robert ArnoldIcahn School of Medicine at Mt Sinai, New York, NY, USA.
Eriko SatomiDepartment of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.
Gregory CrawfordNorthern Adelaide Local Health Network, Adelaide, South Australia, Australia.
Eduardo BrueraUniversity of Texas MD Anderson Cancer Center, Houston, TX, USA.
Carla RipamontiNetwork Italiano Cure Di Supporto in Oncologia (NICSO), Università Degli Studi Di Brescia, Brescia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinicians regularly prescribe opioids to manage acute and chronic cancer pain, frequently to address acute postoperative pain, and occasionally to manage chronic non-cancer pain. Clinical efficacy may be suboptimal in some patients due to side effects and/or poor response, and opioid rotation/switching (conversions) is frequently necessary. Despite the widespread practice, opioid conversion ratios are inconsistent between clinicians, practices, and countries. Therefore, we performed a scoping systematic review of opioid conversion studies to inform an international eDelphi guideline.

methodsTo ensure a comprehensive review, we conducted a systematic search across multiple databases (OVID Medline, PsycINFO, Embase, EBM-Cochrane Database of Systematic Reviews and Registered Trials, LILACS, IMEMR, AIM, WPRIM) using studies published up to June 2022. Additionally, we performed hand and Google Scholar searches to verify the completeness of our findings. Our inclusion criteria encompassed randomized and non-randomized studies with no age limit, with only a few pediatric studies identified. We included studies on cancer, non-cancer, acute, and chronic pain. The level and grade of evidence were determined based on the Multinational Supportive Care in Cancer (MASCC) criteria.

resultsOur search yielded 21,118 abstracts, including 140 randomized (RCT) and 68 non-randomized (NRCT) clinical trials. We compared these results with recently published conversion ratios. Modest correlations were noted between published reviews and the present scoping systematic review.

conclusionThe present scoping systematic review found low-quality evidence to support an opioid conversion guideline. We will use these data, including conversion ratios and type and route of administration, to inform an eDelphi guideline.

Indexed as

Analgesics, OpioidCancer PainAcute PainChronic PainDose-Response Relationship, DrugHumansPractice Guidelines as TopicAnalgesics, OpioidConversionOpioidPainRatioReviewRotationSwitch

Identifiers

PMID39046534

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.