Table 2.
| Statement | USPSTF Evidence Level* | USPSTF Recommendation Grade† | PACC Consensus Level‡ |
|---|---|---|---|
| IT therapy with opioids should be utilized for active cancer-related pain | I | A | Strong |
| IT therapy with ziconotide should be utilized for active cancer-related pain | I | A | Strong |
| IT therapy with opioids should be utilized for active noncancer pain | III | B | Strong |
| IT therapy with ziconotide should be utilized for active noncancer pain | I | A | Strong |
Figure adapted with permission from: Deer et al, The Polyanalgesic Consensus Conference (PACC): Recommendations on intrathecal drug infusion systems best practices and guidelines. Neuromodulation 2017;20(2):96–132 [9]. Additional data reprinted from: Harris RP, Helfand M, Woolf SH, et al. Current methods of the US Preventive Services Task Force: A review of the process. Am J Prev Med 2001;20(3 Suppl):21–35 [40].
IT = intrathecal; PACC = Polyanalgesic Consensus Conference; USPSTF = United States Preventive Services Task Force.
Evidence grades: I, at least one controlled and randomized clinical trial, properly designed; II-1, well-designed, controlled, nonrandomized clinical trials; II-2, cohort or case studies and well-designed controls, preferably multicenter; II-3, multiple series compared over time, with or without intervention and surprising results in noncontrolled experiences; III, clinical experience–based opinions, descriptive studies, clinical observations, or reports of expert committees.
Recommendation grades: A, extremely recommendable (good evidence that the measure is effective and benefits outweigh the harms); B, recommendable (at least moderate evidence that the measure is effective and benefits exceed harms); C, neither recommendable nor inadvisable (at least moderate evidence that the measure is effective, but benefits are similar to harms and a general recommendation cannot be justified); D, inadvisable (at least moderate evidence that the measure is ineffective or that the harms exceed the benefits); I, insufficient, low-quality, or contradictory evidence (the balance between benefit and harms cannot be determined).
Level of consensus among members of the PACC: strong, >80% consensus; moderate, 50% to 79% consensus; weak, <49% consensus.