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Methadone for cancer pain

Overview of attention for article published in Cochrane database of systematic reviews, February 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • Good Attention Score compared to outputs of the same age and source (76th percentile)

Mentioned by

1 blog
41 tweeters
2 Facebook pages


40 Dimensions

Readers on

199 Mendeley
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Methadone for cancer pain
Published in
Cochrane database of systematic reviews, February 2017
DOI 10.1002/14651858.cd003971.pub4
Pubmed ID

Alexander B Nicholson, Graeme R Watson, Sheena Derry, Philip J Wiffen


This is an updated review originally published in 2004 and first updated in 2007. This version includes substantial changes to bring it in line with current methodological requirements. Methadone is a synthetic opioid that presents some challenges in dose titration and is recognised to cause potentially fatal arrhythmias in some patients. It does have a place in therapy for people who cannot tolerate other opioids but should be initiated only by experienced practitioners. This review is one of a suite of reviews on opioids for cancer pain. To determine the effectiveness and tolerability of methadone as an analgesic in adults and children with cancer pain. For this update we searched CENTRAL, MEDLINE, Embase, CINAHL, and clinicaltrials.gov, to May 2016, without language restriction. We also checked reference lists in relevant articles. We sought randomised controlled trials comparing methadone (any formulation and by any route) with active or placebo comparators in people with cancer pain. All authors agreed on studies for inclusion. We retrieved full texts whenever there was any uncertainty about eligibility. One review author extracted data, which were checked by another review author. There were insufficient comparable data for meta-analysis. We extracted information on the effect of methadone on pain intensity or pain relief, the number or proportion of participants with 'no worse than mild pain'. We looked for data on withdrawal and adverse events. We looked specifically for information about adverse events relating to appetite, thirst, and somnolence. We assessed the evidence using GRADE and created a 'Summary of findings' table. We revisited decisions made in the earlier version of this review and excluded five studies that were previously included. We identified one new study for this update. This review includes six studies with 388 participants. We did not identify any studies in children.The included studies differed so much in their methods and comparisons that no synthesis of results was feasible. Only one study (103 participants) specifically reported the number of participants with a given level of pain relief, in this case a reduction of at least 20% - similar in both the methadone and morphine groups. Using an outcome of 'no worse than mild pain', methadone was similar to morphine in effectiveness, and most participants who could tolerate methadone achieved 'no worse than mild pain'. Adverse event withdrawals with methadone were uncommon (12/202) and similar in other groups. Deaths were uncommon except in one study where the majority of participants died, irrespective of treatment group. For specific adverse events, somnolence was more common with methadone than with morphine, while dry mouth was more common with morphine than with methadone. None of the studies reported effects on appetite.We judged the quality of evidence to be low, downgraded due to risk of bias and sparse data. For specific adverse events, we considered the quality of evidence to be very low, downgraded due to risk of bias, sparse data, and indirectness, as surrogates for appetite, thirst and somnolence were used.There were no data on the use of methadone in children. Based on low-quality evidence, methadone is a drug that has similar analgesic benefits to morphine and has a role in the management of cancer pain in adults. Other opioids such as morphine and fentanyl are easier to manage but may be more expensive than methadone in many economies.

Twitter Demographics

The data shown below were collected from the profiles of 41 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 199 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 2 1%
United Kingdom 1 <1%
Denmark 1 <1%
Unknown 195 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 31 16%
Student > Master 29 15%
Student > Bachelor 22 11%
Other 21 11%
Student > Ph. D. Student 16 8%
Other 51 26%
Unknown 29 15%
Readers by discipline Count As %
Medicine and Dentistry 95 48%
Nursing and Health Professions 20 10%
Pharmacology, Toxicology and Pharmaceutical Science 8 4%
Psychology 8 4%
Agricultural and Biological Sciences 7 4%
Other 29 15%
Unknown 32 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 31. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 July 2017.
All research outputs
of 13,436,295 outputs
Outputs from Cochrane database of systematic reviews
of 10,595 outputs
Outputs of similar age
of 346,258 outputs
Outputs of similar age from Cochrane database of systematic reviews
of 216 outputs
Altmetric has tracked 13,436,295 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 10,595 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.9. This one has done well, scoring higher than 84% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 346,258 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 216 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 76% of its contemporaries.