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Vol. 113 No. 4 April 2012

Lhe therapeutic effects ofticonvulsants in the treatment ofofacial pain

the Editor:We took great pleasure in reading the article titled Theficacy of Anticonvulsants on Orofacial Pain: Astematic Review1 by Martin and Forouzanfar. Wepreciate the efforts made by the authors in review-

the literature and compiling this review concern-a subject of extreme value. However, there are aareas of concern in the methodology that need

rification.

In the methodologic 15-item criteria score, the cri-teria labeled F and G seem to be the same.

The corresponding article as referenced by the au-rs, de Vet and de Bie,2 shows that the criterioneled F should have been loss to follow-up, rathern intervention as the review article suggests.Moreover, the criterion labeled G in the originalicle is subdivided into 2 separate criteria: #1ex-rimental; name: and #2placebo or other control;me, which is not the same as in the 15-item criteria of

review article.We are keen to know whether the authors modified

original 15-item criteria for convenience.

The scoring system depicted in their Table I was notvery easy to comprehend, especially when an at-tempt at blinding was given a higher score comparedwith successful blinding.

A clarification on these points would definitely addthe scientific literature and help in future studies. Wepreciate the fact that the article has highlighted theucity of randomized controlled trials to evaluate thecacy of therapy for orofacial pain and that it moti-

ted us to carry out similar studies.

Pramod Krishna Majumdar, MDSSunil Mutalik, MDS

Keerthilatha M. Pai, MDSDepartment of Oral Medicine and Radiology

Manipal College of Dental SciencesManipal University, Manipal, India

FERENCES

ETTERS TO THE EDITORMartin WJJ, Forouzanfar T. The efficacy of anticonvulsants onorofacial pain: a systematic review. Oral Surg Oral Med OralPathol Oral Radiol Endod 2011;111:627-33.

scimo

vade Vet HCW, de Bie RA. Systematic reviews on the basis ofmethodological criteria. Physiotherapy 1997;83:284-9.

:10.1016/j.oooo.2011.09.019

he therapeutic effects ofticonvulsants in the treatment ofofacial pain

reply:With great interest we read this letter to the editor.e greatly appreciate the curiosity for more details ofr study.In addition to our explanation in the Materials andethods, we should mention that we used the 15-itemteria list of Forouzanfar et al. published in the Eu-pean Journal of Pain.1 This list, with some altera-ns, was developed by the University of Maastrichtd the Free University, Amsterdam. These modifica-ns were made to evaluate randomized controlledals concerning pain in a more significant way. Thiso resulted in a new distribution of points per item.Changes made in the criteria list were discussed withthor H.C.W. de Vet. As we noted in earlier publisheddies, different criteria lists with different weighting ofres have been used.2-5 Important items, which must bered to make firm conclusions about a randomized

ntrolled trial, are described by van Tulder et al.6,7 andrhagen et al.8 To generate a quality assessment indomized controlled trials, a generic core set of itemss selected. These can be found in the Cochrane Backview Group Internal Validity Checklist from Tulder et7 and in the Delphi List of Verhagen et al.8 As youy see, loss to follow-up was not included.When the 15-item criteria list of Forouzanfar et al.s developed, every item was again weighted. There-e, a new distribution of points per item was made.r example, we can see that more points were giventhe analysis and presentation of data, which partlyludes the statistical analysis of the loss to follow-. An attempt at blinding was given a higher score,cause the process of blinding is almost never evalu-d in a randomized controlled trial.Overall, it is hard to define a criteria list that mightction as a gold standard. You may have to combineferent criteria lists and different guidelines for system-c reviews to optimize your own systematic review.We hope that our given explanation will add to the

entific literature and help in future studies. Further-re, we are happy to hear that our study might moti-

te others to carry out similar research.

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The therapeutic effects of anticonvulsants in the treatment of orofacial painReferences