Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials

Overview of attention for article published in British Medical Journal, April 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#45 of 31,624)
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (99th percentile)

Mentioned by

news
56 news outlets
blogs
10 blogs
twitter
678 tweeters
peer_reviews
1 peer review site
facebook
150 Facebook pages
wikipedia
3 Wikipedia pages
googleplus
14 Google+ users
reddit
1 Redditor
video
2 video uploaders

Readers on

mendeley
139 Mendeley
citeulike
1 CiteULike
Title
Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials
Published in
British Medical Journal, April 2015
DOI 10.1136/bmj.h1225
Pubmed ID
Authors

Gustavo C Machado, Chris G Maher, Paulo H Ferreira, Marina B Pinheiro, Chung-Wei Christine Lin, Richard O Day, Andrew J McLachlan, Manuela L Ferreira, Machado, Gustavo C, Maher, Chris G, Ferreira, Paulo H, Pinheiro, Marina B, Lin, Chung-Wei Christine, Day, Richard O, McLachlan, Andrew J, Ferreira, Manuela L, G. C. Machado, C. G. Maher, P. H. Ferreira, M. B. Pinheiro, C.-W. C. Lin, R. O. Day, A. J. McLachlan, M. L. Ferreira

Abstract

To investigate the efficacy and safety of paracetamol (acetaminophen) in the management of spinal pain and osteoarthritis of the hip or knee. Systematic review and meta-analysis. Medline, Embase, AMED, CINAHL, Web of Science, LILACS, International Pharmaceutical Abstracts, and Cochrane Central Register of Controlled Trials from inception to December 2014. Randomised controlled trials comparing the efficacy and safety of paracetamol with placebo for spinal pain (neck or low back pain) and osteoarthritis of the hip or knee. Two independent reviewers extracted data on pain, disability, and quality of life. Secondary outcomes were adverse effects, patient adherence, and use of rescue medication. Pain and disability scores were converted to a scale of 0 (no pain or disability) to 100 (worst possible pain or disability). We calculated weighted mean differences or risk ratios and 95% confidence intervals using a random effects model. The Cochrane Collaboration's tool was used for assessing risk of bias, and the GRADE approach was used to evaluate the quality of evidence and summarise conclusions. 12 reports (13 randomised trials) were included. There was "high quality" evidence that paracetamol is ineffective for reducing pain intensity (weighted mean difference -0.5, 95% confidence interval -2.9 to 1.9) and disability (0.4, -1.7 to 2.5) or improving quality of life (0.4, -0.9 to 1.7) in the short term in people with low back pain. For hip or knee osteoarthritis there was "high quality" evidence that paracetamol provides a significant, although not clinically important, effect on pain (-3.7, -5.5 to -1.9) and disability (-2.9, -4.9 to -0.9) in the short term. The number of patients reporting any adverse event (risk ratio 1.0, 95% confidence interval 0.9 to 1.1), any serious adverse event (1.2, 0.7 to 2.1), or withdrawn from the study because of adverse events (1.2, 0.9 to 1.5) was similar in the paracetamol and placebo groups. Patient adherence to treatment (1.0, 0.9 to 1.1) and use of rescue medication (0.7, 0.4 to 1.3) was also similar between groups. "High quality" evidence showed that patients taking paracetamol are nearly four times more likely to have abnormal results on liver function tests (3.8, 1.9 to 7.4), but the clinical importance of this effect is uncertain. Paracetamol is ineffective in the treatment of low back pain and provides minimal short term benefit for people with osteoarthritis. These results support the reconsideration of recommendations to use paracetamol for patients with low back pain and osteoarthritis of the hip or knee in clinical practice guidelines. PROSPERO registration number CRD42013006367.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 139 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 4 3%
Australia 3 2%
Spain 2 1%
United Kingdom 2 1%
Japan 2 1%
France 1 <1%
Argentina 1 <1%
Unknown 124 89%

Demographic breakdown

Readers by professional status Count As %
Other 40 29%
Student > Bachelor 25 18%
Researcher 21 15%
Student > Master 15 11%
Student > Ph. D. Student 10 7%
Other 28 20%
Readers by discipline Count As %
Medicine and Dentistry 108 78%
Agricultural and Biological Sciences 6 4%
Social Sciences 5 4%
Nursing and Health Professions 4 3%
Neuroscience 3 2%
Other 13 9%

Attention Score in Context

This research output has an Altmetric Attention Score of 1062. 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 14 February 2017.
All research outputs
#1,196
of 7,431,429 outputs
Outputs from British Medical Journal
#45
of 31,624 outputs
Outputs of similar age
#62
of 197,074 outputs
Outputs of similar age from British Medical Journal
#2
of 673 outputs
Altmetric has tracked 7,431,429 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 31,624 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.9. This one has done particularly well, scoring higher than 99% 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 197,074 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 99% of its contemporaries.
We're also able to compare this research output to 673 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.