Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study
, Andrew A. Somogyi 4, Justin Rubio 5, Tien Dung Pham 3, Brian Le 1,2,3, Pal Klepstad 6 and Jennifer Philip 1,2,3
Piotr Z. Sobanski
Round 1
Reviewer 1 Report
Excelent real life study. The atuthors should discuss in more detail the inception point for the study, and the high frequency of disgnosis of a need to rotate opioids
Author Response
Thank you for your comment. In this study, those who required opioid switch were recruited into the switch group, and those who did not require opioid switch were recruited into the control group. Their outcomes were then compared to each other. Recruitment was not dependent on frequency of need for opioid switch – we simply recruited patients to the study who needed opioid switch, meaning that the need for opioid switch was first identified, then the potential participant was approached to enter the study. Lines 85-88 have been modified to clarify this.
Reviewer 2 Report
Major concerns
1. In the manuscript – the decision making to which opioid will be switched and the rationale for this is missing, and the choice of a new opioid is one of difficult questions.
2. What I am missing in the text – are the criteria for successful opioid rotation, they could be included.
Minor concerns
Line 204 – I am wondering if making the information more precise and adding a word “improvement in* writing about “pain score outcomes post-switch” would not make the text easier to understand.
Line 214 – the statement “three or less” corresponds to NRS?
Editing:
Line 52 – one empty space too much
Author Response
Please see the attachment
Author Response File: 
Author Response.pdf
