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Study flow diagram.
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Figure 1

Study flow diagram.

'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study.
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Figure 2

'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study.

NSAID for cancer pain ‐ non‐controlled data

Patient or population: people with cancer pain

Settings: inpatient or outpatient

Intervention: any NSAID, and dose

Comparison: no control ‐ cohort of treated participants

Outcomes

Probable outcome with NSAID

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Participants with at least 30% or at least 50% reduction in pain

No data

No data

Very low

Limited data, several risks of bias

PGIC much or very much improved

No data

No data

Very low

Limited data, several risks of bias

Pain no worse than mild at one or two weeks (or equivalent)

Range of estimates from 260 in 1000 to 510 in 1000

4 studies

415 participants randomised

Very low

Limited data, several risks of bias

Serious adverse events

2 serious adverse events reported

11 studies

949 participants

Very low

Limited data, several risks of bias

Adverse events

Dry mouth 10%

Loss of appetite 4%

Somnolence 9%

Dyspepsia 9%

Variously reported in studies

Very low

Limited data, several risks of bias

Withdrawals

All cause 23%

Lack of efficacy 24%

Adverse event 5%

Variously reported in studies

Very low

Limited data, several risks of bias

Death

22 deaths, not clearly related to treatment

11 studies

949 participants

Very low

Limited data, several risks of bias

Descriptors for levels of evidence (EPOC 2015):
High quality: This research provides a very good indication of the likely effect. The likelihood that the effect will be substantially different is low.
Moderate quality: This research provides a good indication of the likely effect. The likelihood that the effect will be substantially different is moderate.
Low quality: This research provides some indication of the likely effect. However, the likelihood that it will be substantially different is high.
Very low quality: This research does not provide a reliable indication of the likely effect. The likelihood that the effect will be substantially different is very high.

Substantially different: a large enough difference that it might affect a decision.

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