Methodological Issues in the Design of Analgesic Clinical Trials
This chapter discusses some of the firm conclusions from the experience of analgesic research and highlights areas of analgesic trial methodology that have had relatively little exploration, particularly repeated-dose studies in chronic pain, where an ongoing dialogue among symptom researchers might move all of these fields ahead. Several generations of analgesic researchers have come to a consensus on approaches to single-dose analgesic studies. Because the studies of other symptoms may share some of the same challenges, palliative care researchers may benefit from a familiarity with the analgesic study design literature. However, many clinical research problems with pain and other symptoms have received rather little study, including optimizing the sensitivity of symptom-based measures, combination studies, and the choice of control groups in repeated-dose studies. The solution to many of these problems may be facilitated by frequent discussions among clinical researchers working in different symptom areas.
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