To evaluate whether sponsorship influences the reporting of positive results and the occurrence of selective outcome reporting (SOR) in randomised controlled trials (RCTs) investigating pharmacologic interventions for postoperative pain management following third molar extraction.
This meta-research included RCTs comparing at least one active drug with placebo, two active drugs, or combination thereof, and reporting outcomes related to pain reduction after third molar extraction. Searches were conducted in PubMed, Scopus and Web of Science without date restrictions and last search was performed on 2024 August. Study selection was performed in Rayyan QCRI, with two independent reviewers screening titles, abstracts and full texts. Data extraction was also conducted independently by two reviewers, collecting information on year of publication, trial design, number of groups, placebo comparisons, sample size (number of patients/teeth), follow-up losses, statistical significance of results, protocol registration and funding disclosures. Selective outcome reporting was assessed by comparing registered protocols with published outcomes. Associations between sponsorship status and both SOR and positive result reporting were analysed using chi-square test (α = 0.05).
A total of 430 RCTs were included. No association was found between sponsorship status and SOR (p = 0.861), nor between sponsorship status and the reporting of positive results (p = 0.241).
In this sample, sponsorship was not associated with either selective outcome reporting or the likelihood of reporting positive results in RCTs on postoperative pain management after third molar extraction.
The absence of sponsorship bias in RCTs on third molar extraction suggests that industry-funded and non-sponsored studies provide comparably reliable evidence, supporting clinicians in making unbiased, evidence-based decisions for postoperative pain management in third molar surgery.
Expectations shape therapeutic outcomes, yet their systematic assessment remains limited in clinical and research settings. To address this gap, we developed and validated the Brief Instrument for the Assessment of Treatment Expectations in Chronic Pain (BITEC) using Item Response Theory.
The study comprised four phases. (I) Twenty-one items were generated from expectation constructs and refined to 11 through a Delphi review (≥ 80% agreement). (II) Comprehensibility was tested in 30 women with fibromyalgia, and the scale was applied to 484 chronic pain patients; items (0–10) were recoded into four categories, and IRT reduced them to nine. (III) The final version was administered to 1127 adults with chronic pain (79.3% fibromyalgia; 20.7% nociceptive/neuropathic), and latent-class modelling defined low–high expectation cutoffs. (IV) Construct validity was assessed via discriminant analyses in calibration (n = 1127) and validation (n = 242) samples to evaluate whether BITEC levels differentiated diagnostic groups, pain impact and catastrophizing. (V) We developed a bedside app to support expectation-level classification.
The nine-item BITEC showed discrimination between high and low expectations (AUC 0.915; 95% CI 0.897–0.933; sensitivity 79%, specificity 96%). Across both samples, BITEC demonstrated construct validity, distinguishing expectation categories based on symptom severity, catastrophizing and pain burden. Expectation levels varied across pain phenotypes, decreasing from nociceptive pain (56.1%) to fibromyalgia (42.7%) and multiple pain conditions (26.9%). Higher symptom severity was associated with higher expectations.
BITEC is a brief, reliable, theory-grounded instrument for stratifying treatment expectations in chronic pain; applicability across treatment modalities and clinical contexts warrants further investigation.
Expectations strongly shape therapeutic outcomes but remain difficult to measure. The BITEC, a brief IRT-based tool, offers a reliable way to classify treatment expectations in chronic pain, supporting personalised care and improving clinical decision-making.
Espinós Ramírez C, Castellví Obiols P, Martínez-Rodríguez D et al. Acute Postoperative Pain After Caesarean Section, Intensity and Management: A Cohort Multicentre Study. Eur J Pain. 2026; 30: e70183. doi:10.1002/ejp.70183.
The title of this paper was corrected to read as follows: ‘Chronic Postoperative Pain After Caesarean Section, Characteristics and Risk Factors: A Cohort Multicentre Study’ because it focuses on chronic post-surgical pain following elective caesarean section.
In Section 4: Discussion, Paragraph 4, Line 3 in reference to impact of neuropathic pain on quality of life, the sentence should read as follows: ‘Our subset of patients reporting neuropathic characteristics show worse significant quality of life ratings except for impact on humour’.
We apologise for these errors.
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