<i>The Cochrane Library</i> and sickle cell disease: an overview of reviews
Bibliographic record
Abstract
Abstract Background Sickle cell disease is a genetically inherited red blood cell disorder which features pain as a predominant manifestation. Objectives To review the evidence within Cochrane systematic reviews on the management of pain associated with vaso‐occlusive crises and priapism secondary to sickle cell disease in paediatric populations. Methods The Cochrane Library of Systematic Reviews was searched for all reviews that addressed interventions to relieve pain associated with sickle cell disease. Reviews that primarily addressed the reduction of sickle cell crises were excluded. Data were extracted from included reviews. Results Three reviews were included. One review examined pharmacological interventions to relieve pain associated with vaso‐occlusive pain crises. One trial in children reported a significant reduction in VAS scores associated with ketorolac administration versus pethidine, but another trial performed in adults showed no significant reduction in VAS scores when ketorolac was compared to placebo. Two trials found that parenterally delivered corticosteroids reduced the length of analgesic therapy compared to placebo, and another trial found that there was no difference in the pain scores of children when morphine was delivered either parenterally or orally. Two trials reported on long‐term psychological interventions to manage pain. One found that coping skills training in children resulted in a reduction in the tendency to report pain, while the other trial found that cognitive behavioural therapy in adolescents and adults resulted in a decrease in the emotional component of pain but not the sensory component. One review addressed the treatment of stuttering priapism in boys and men using stilboestrol, but included an insufficient number of patients to draw a conclusion. Authors' Conclusions Pharmacological interventions to treat vaso‐occlusive pain crises show mixed results in the use of ketorolac and no difference between parenteral versus oral administration of morphine. Psychological interventions for vaso‐occlusive crises demonstrated benefit in improving some components of pain. Evidence regarding treatment of priapism was weak. Further studies should employ multi‐centre trials and begin to address generalisability concerns by more focus in Africa, where the majority of patients with sickle cell disease reside. Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.007 |
| Bibliometrics | 0.019 | 0.028 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.021 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".