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Table 7 Pain

From: A systematic review and meta-analysis of risks and benefits with breast reduction in the public healthcare system: priorities for further research

Author
Year
Country
Study design Number of patients Withdrawals-dropouts Intervention
Breast reduction
Mean (SD)
Control
No surgery
Mean (SD)
P values denote intergroup difference if not otherwise depicted
Comments Directness* Study limitations* Precision*
Iwuagwu
2006
UK [31]
RCT 73
I: 36
C: 37
0 EQ-5D
Pain:
Baseline: 1.88 (0.46)
4 months: 1.46 (0.57)
EQ-5D
Pain:
Baseline: 1.94 (0.52)
4 months: 2.05 (0.52)
p < 0.001
MD 0.59
EuroQol EQ-5D: The European Quality of Life-5 Dimensions
Pain assessment scores are part of the questionnaire. Lower score = less pain, range 1–3
? ? ?
Saariniemi
2008
Finland [34]
RCT 82
I: 40
C: 42
18
I: 11
C: 7
FBAS
11.8 (SD NR)
FBAS
57.9 (SD NR)
MD − 46.1 (95% CI − 49.8 to
− 40.7), p < 0.0001
FBAS: Finnish Breast Associated Symptoms questionnaire (Higher scores = more symptoms, range 0–100) ?/ +  ?  + 
     FPQ
7.0 (SD NR)
FPQ
26.5 (SD NR)
MD − 19.5 (95% CI − 25.2 to
− 14.3), p < 0.0001
FPQ: Finnish Pain Questionnaire (Higher scores = more pain, range 0–100)    
Freire
2007
Brazil [37]
RCT 100
I: 50
C: 50
8
I: 4
C: 4
VAS:
Lower back
Baseline: 5.7 (2.7)
6 months: 1.3 (2.5)
VAS:
Lower back pain
Baseline: 6.0 (3.3)
6 months: 5.3 (2.8)
p < 0.001
VAS: Visual analogue scale (0: No pain, 10: Intense pain
Same cohort as Neto et al. [36]. Lower back pain data identical
 +  ?/− ?
     Shoulders
Baseline: 6.1 (2.7)
6 months: 1.1 (1.8)
p < 0.001 (intragroup difference)
Shoulders
Baseline: 6.2 (3.2)
6 months: 6.9 (2.6)
p < 0.001
NS (intragroup difference)
A MID of 0.9 has been suggested for VAS [66]    
     Neck
Baseline: 5.2 (2.9)
6 months: 0.9 (1.3)
p < 0.001 (intragroup difference)
Neck
Baseline: 4.7 (3.6)
6 months: 5.1 (3.1)
p < 0.001
NS (intragroup difference)
    
Hermans
2005
Netherlands [43]
Non-randomized controlled study 165
I: 94
C: 71
10
I: 10
C: 0
SF-36
Pain: 77.65
SF-36
Pain: 57.00 p < 0.001
MD 21
SF-36: Short Form-36 Health survey (higher score = better health, range 0–100) ? ?/− ?
     EQ-5D
Pain:
No problems: 51.2%
Some problems: 44.0% Many problems: 4.8%
EQ-5D
Pain:
No problems: 14.1%
Some problems: 78.9%
Many problems: 7.0%
p < 0.001
EQ-5D: The European Quality of Life-5 Dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Only 2 dimensions stated in article    
     DAS-59
Pain:
Almost never: 68%
Sometimes: 22%
Always/Often: 10%
DAS-59
Pain:
Almost never: 2%
Sometimes: 18%
Always/Often: 80%
p < 0.001
DAS-59: Derriford Appearance Scale 59. Higher scores indicate greater problems
Pain scores were all part of QoL-questionnaires
   
  1. NR not reported, NS no significance, EQ-5D The European Quality of Life-5 Dimensions, FBAS Finnish Breast Associated Symptoms questionnaire, FPQ Finnish Pain Questionnaire, VAS visual analogue scale, SF-36 Short Form-36 Health survey, DAS-59 Derriford Appearance Scale 59
  2. * + No or minor problems; ? Some problems; - Major problems