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. 2018 Oct 1;2018(9):CD003968. doi: 10.1002/14651858.CD003968.pub5

Palermo 2016.

Study characteristics
Methods RCT. 2 arms. Assessed at pretreatment, post‐treatment and 3 month follow‐up
Participants End of treatment: n = 60, 3 month follow‐up: n = 59
Start of treatment: n = 61
Child sex: 49 F, 11 M
Parent sex: 60 F, 1 M
Child mean (SD) age = 14.07 years (1.80)
Source = pain clinic
Diagnosis = mixed chronic pain conditions
Mean years of pain = unknown
Interventions "Problem‐solving skills training"
"Treatment‐as‐usual"
Outcomes Primary pain outcome: Child pain intensity
Primary disability outcome: Physical disability (BAPQ)
Primary depression outcome: Depression (BAPQ)
Primary anxiety outcome: General anxiety (BAPQ)

  1. Child‐reported measures:

    1. Pain intensity

    2. Bath Adolescent Pain Questionnaire

    3. Adverse events

  2. Parent‐reported measures:

    1. Beck Depression Inventory

    2. Profile of Mood States

    3. Bath Adolescent Pain – Parental Impact Questionnaire

    4. Pain Catastrophizing Scale ‐ Parents

    5. Brief Symptoms Inventory

    6. Short Form Health Survey 12

    7. Parenting Stress Index ‐ Short Form

    8. Helping for Health Inventory

    9. Treatment Evaluation Inventory ‐ Short form

    10. Adverse events
Notes COI: "The authors have no conflicts of interest to declare."
Funding: "Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R21HD065180 (PI: T. M. P.)."
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk "A fixed allocation randomization scheme was used. The order of randomization to the 2 treatment conditions was generated separately for each site with an online program (randomizer.org). A blocked method design was used, with blocks of 4 for each identification number"
Comment: probably done
Allocation concealment (selection bias) Low risk "Only the research coordinator had the password to the randomization table. Group assignment was concealed by formatting the document to block out group assignment until the time of randomization."
Comment: probably done
Blinding of outcome assessment (detection bias)
All outcomes Low risk "All study assessments were self‐report measures completed in participants’ homes through mailings; children and parents were instructed to complete the measures independently."
Comment: probably done
Incomplete outcome data (attrition bias)
All outcomes Low risk Attrition was fully reported and there were no differences between completers and non‐completers
Selective reporting (reporting bias) Low risk All data were fully reported