Guidelines for Complications of Cancer Treatment Vol VIII Part B

outcomes that may result from the undertreatment ofperioperative pain are thromboembolic and pulmonarycomplications, increase length of stay in the intensive careunit or hospital, hospital readmission for further painmanagement, needless suffering, impairment of health-relatedquality of life, and development of chronic pain.Adverse outcomes associated with the management ofperioperative pain are respiratory depression, brain or otherneurologic injury, sedation, circulatory depression, nausea,vomiting, pruritus, urinary retention, impairment of bowelfunction, and sleep disruption.The following terms describe the strength of the findings. Supportive: Meta-analyses of a sufficient number ofadequately designed studies indicate a statisticallysignificant relationship (P _ 0.01) between a clinicalintervention and a clinical outcome. Suggestive: Information from case reports anddescriptive studies permits inference of a relationshipbetween an intervention and an outcome. This type ofqualitative information does not permit a statisticalassessment of significance. Equivocal: Qualitative data are not adequate to permitinference of a relationship between an intervention andan outcome and (1) there is insufficient quantitativeinformation, or (2) aggregated comparative studies havefound no significant differences among groups orconditions. The lack of scientific evidence in theliterature is described by the following terms. Silent: No identified studies address the relationship ofinterest. Insufficient: There are too few published studies toinvestigate a relationship between an intervention andan outcome.56