The study by O'Bryant et al.describes inconsistencies in published opioid equianalgesic conversion ratios and how these variations can have implications for both research and clinical practice. The authors convincingly illustrate the,ir argument by applying conversion ratios from commonly used, widely accepted, and easily accessible resources to individual patient cases from a study of 105 advanced cancer patients. Depending on the resource used, the authors report a 1.5-, 2-, or 100-fold difference when converting to IV morphine from oxy-codone, transdermal fentanyl or methadone, respectively. However, in Tables 4 and 5 it appears that the authors have misinterpreted those conversion ratios recommended by Ripamonti et al.
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