Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,655 questions · 1,751 findings · 147 reviews · Pain, Palliative and Supportive Care

No studies found 361 · 20.6%GRADE not reported 87 · 5%Very low 625 · 35.7%Low 367 · 21%Moderate 232 · 13.2%High 79 · 4.5%

Intervention not reported

Participants with at least 1 adverse event (all diclofenac potassium doses, 25 mg to 100 mg) · Adults with acute pain

The intervention showed no clear difference in participants with at least 1 adverse event (all diclofenac potassium… (moderate certainty).

1 finding from 1 review

Single‐fraction radiotherapy (8 Gy) vs short‐course radiotherapy (16 Gy

Ambulation · adults with metastatic extradural spinal cord compression (poor prognosis with visceral metastasis, and no spinal instability or bony…

Single‐fraction radiotherapy (8 Gy) showed no clear difference in ambulation One month after radiation compared with short‐course radiotherapy (16 Gy (moderate certainty).

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Reduction in analgesic and narcotic use One month after radiation · adults with metastatic extradural spinal cord compression (poor prognosis, no spinal instability or bony impingement of cord)

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in reduction in analgesic and narcotic use One month after radiation compared with short‐course radiotherapy (2 fractions, 16 Gy) (moderate certainty).

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Urinary continence One month after radiation · adults with metastatic extradural spinal cord compression (poor prognosis, no spinal instability or bony impingement of cord)

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in urinary continence One month after radiation compared with short‐course radiotherapy (2 fractions, 16 Gy) (moderate certainty).

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Local recurrence · adults with metastatic extradural spinal cord compression (poor prognosis, no spinal instability or bony impingement of cord)

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in local recurrence compared with short‐course radiotherapy (2 fractions, 16 Gy) (low certainty).

1 finding from 1 review

Split‐course radiotherapy (8 fractions, 30 Gy) vs short‐course radiotherapy (16 Gy

Adverse events Grade 3 oesophagitis, diarrhoea and nausea · adults with metastatic extradural spinal cord compression (poor prognosis, no spinal instability or bony impingement of cord)

Split‐course radiotherapy (8 fractions, 30 Gy) showed no clear difference in adverse events Grade 3 oesophagitis, diarrhoea, and nausea compared with short‐course radiotherapy (2 fractions, 16 Gy) (moderate certainty).

1 finding from 1 review

Laminectomy plus radiotherapy vs radiotherapy

Ambulation · adults with metastatic extradural spinal cord compression (single lesion, no prior radiotherapy, fit for surgery)

It is very uncertain whether laminectomy plus radiotherapy changes ambulation At four months compared with radiotherapy (very low certainty).

1 finding from 1 review

Laminectomy plus radiotherapy vs radiotherapy

Survival At four months · adults with metastatic extradural spinal cord compression (single lesion, no prior radiotherapy, fit for surgery)

It is very uncertain whether laminectomy plus radiotherapy changes survival At four months compared with radiotherapy (very low certainty).

1 finding from 1 review

Laminectomy plus radiotherapy vs radiotherapy

Reduced use of analgesics · adults with metastatic extradural spinal cord compression (single lesion, no prior radiotherapy, fit for surgery)

It is very uncertain whether laminectomy plus radiotherapy changes reduction in analgesic use compared with radiotherapy (very low certainty).

1 finding from 1 review

Laminectomy plus radiotherapy vs radiotherapy

Urinary continence One month after radiation · adults with metastatic extradural spinal cord compression (single lesion, no prior radiotherapy, fit for surgery)

It is very uncertain whether laminectomy plus radiotherapy changes urinary continence One month after treatment compared with radiotherapy (very low certainty).

1 finding from 1 review

Decompressive surgery plus radiotherapy vs radiotherapy

Ambulation · adults with metastatic extradural spinal cord compression (fit for surgery, paraplegic less than 48 hours, and without multiple discrete…

Decompressive surgery plus radiotherapy may leads to higher ambulation Immediately after completing RT compared with radiotherapy (low certainty).

1 finding from 1 review

Decompressive surgery plus radiotherapy vs radiotherapy

Survival (short term) At 30 days · adults with metastatic extradural spinal cord compression (fit for surgery, paraplegic less than 48 hours, and without multiple discrete…

Decompressive surgery plus radiotherapy showed no clear difference in survival (short term) At 30 days compared with radiotherapy (low certainty).

1 finding from 1 review