As The Cochrane Collaboration celebrates its 20th anniversary, we recall the Cochrane Pain, Palliative and Supportive Care (PaPaS) Review Group's first published review, which looked at treating any acute or chronic pain with any antiepileptic drug, at any dose. Already an update of a 1995 review published in the BMJ, this 1998 Cochrane Review was itself updated in 2005, and subsequently withdrawn in 2010. Although in the earlier versions we attempted to differentiate neuropathic pain conditions such as painful diabetic neuropathy or postherpetic neuralgia, there were too few studies with too few patients treated with any one drug in any one condition to afford any subtle insights. For the full editorial simply click on the link: http://www.thecochranelibrary.com/details/editorial/4795981/Growing-pain-striving-for-quality-relevance-and-applicability-in-Cochrane-Review.html
The Cochrane Collaboration is a unique partnership of the very best of minds, pursuing answers to the most important of questions. We rarely spend time looking back. This quick glance at history has reinforced how important it is to leave our growing pains behind and focus on growing the evidence base for pain. There are important societal questions that require evidence. Headache, migraine, and musculoskeletal disorders remain major problems for all societies. Neuropathic pain is a growing problem associated with ageing and the increase in diabetes. Complex problems of iatrogenisis are emerging, not least from opioid prescribing which is a particular problem that will require our serious attention in the future. Our first 15 years of publishing have been no better than adequate. Consumers of our reviews want us to do more. Patients encourage us to be more courageous. We want to do more, and we can do more. We have plans for growth and we look forward to growing together with our colleagues from across the Collaboration.