PT  - JOURNAL ARTICLE
AU  - Ekström, Magnus
AU  - Bajwah, Sabrina
AU  - Bland, J Martin
AU  - Currow, David C
AU  - Hussain, Jamilla
AU  - Johnson, Miriam J
TI  - One evidence base; three stories: do opioids relieve chronic breathlessness?
AID  - 10.1136/thoraxjnl-2016-209868
DP  - 2018 Jan 01
TA  - Thorax
PG  - 88--90
VI  - 73
IP  - 1
4099  - http://thorax.bmj.com/content/73/1/88.short
4100  - http://thorax.bmj.com/content/73/1/88.full
SO  - Thorax2018 Jan 01; 73
AB  - The efficacy of low-dose systemic opioids for chronic breathlessness was questioned by the recent Cochrane review by Barnes et al. We examined the reasons for this conflicting finding and re-evaluated the efficacy of systemic opioids. Compared with previous meta-analyses, Barnes et al reported a smaller effect and lower precision, but did not account for matched data of crossover trials (11/12 included trials) and added a risk-of-bias criterion (sample size). When re-analysed to account for crossover data, opioids decreased breathlessness (standardised mean differences −0.32; −0.18 to −0.47; I2=44.8%) representing a clinically meaningful reduction of 0.8 points (0–10 numerical rating scale), consistent across meta-analyses.