In every industry, from education to healthcare to travel, the generation of quantitative data is considered important to maintain quality through competition.
Yet statistics rarely show what they see.
If you look at recent airline statistics, you’ll think that a far higher number of planes are arriving on schedule or early than ever before. But this appearance of improvement is deceptive.
Airlines have become experts at appearance management: by listing flight times as 20-30 percent longer than what the actual flight takes, flights that operate on a normal to slightly delayed schedule are still counted as arriving ‘early’ or ‘on time’. A study funded by the Federal Aviation Administration refers to the airline tactic as schedule buffering. Continue reading
Insufficient Evidence: How Opioid Deniers Spin Studies — Pain News Network – By Roger Chriss – April 2017
Researchers cannot and do not investigate if “opioids” work for “chronic pain.”
Good research is more narrowly focused, such as these clinical studies:
- “Tapentadol extended release for the management of chronic neck pain”
- “Effectiveness and Safety of Once-Daily Extended-Release Hydrocodone in Individuals Previously Receiving Immediate-Release Oxycodone for Chronic Pain”
- “Oxycodone for neuropathic pain in adults”
The results are equally specific. Continue reading
This document, which I found on a hospital website and annotated below, is a leftover from the “good old days” when doctors were actually obliged to provide effective pain care (and even too much in too many cases).
In the 1990’s, a lot of effort and money was spent trying to convince the public that opioids were safe if used responsibly for legitimate pain control – which they truly are, of course. Or they were before 2000, when the pendulum started heading back to the demonization of all opioids.
All the money spent publicizing and advocating for the use of opioids for proper pain control before 2000 is dwarfed by the amounts now being spent to demonize those very same opioids. Compassion for people with chronic pain evaporated. Suddenly we became lazy and self-indulgent addicts, and we were shunned. Continue reading
Hyperalgesia: No Reason to Stop or Reduce Opioids – May 30, 2017 – by Forest Tennant M.D., Dr. P.H.
One of the excuses that some health practitioners are using to stop opioids is to claim a patient has hyperalgesia (HA).
This is a most dishonest, devious, and dangerous ploy.
First, the definition of hyperalgesia is simply that a stimulus such as hitting your thumb with a hammer is more painful than usual.
Second, there is no way to measure or quantify the presence of HA in a chronic pain patient who takes opioids. Continue reading
Want More Trust in Medical Science? Embrace Uncertainty and Cut the Hype – John Mandrola, MD – April 2017
…in this week of righteous celebration of science, certainty will be favored over uncertainty, as will acceptance over skepticism.
This, I believe, is a core reason science has a trust problem. An old mentor warned me of the danger of hubris. Hubris, he said, was the doctor’s greatest enemy.
I see a lot of overconfidence in medical science. Continue reading
This turns out to be a lesson in BS detection: an old article citing decades-old research repurposed as though new.
The association between anxiety disorders and pain may be stronger than the association between depression and pain. Learn more about the most common anxiety disorders seen in pain patients, as well as new DSM-5 diagnostic criteria.
I checked the 62 references supplied at the end of the article and found that half are from the previous century: Continue reading
Adverse events (AEs) are harmful or undesirable outcomes that occur during or after the use of a drug or intervention but are not necessarily caused by it.
Serious or important adverse events may occur rarely and, consequently, systematic reviews and meta-analyses that synthesize harms data from numerous sources (potentially involving both published and unpublished datasets) can provide greater insights.
The Database of Abstracts of Reviews of Effects (DARE) includes 104 reviews of adverse events published in 2010 and 344 in 2014. Continue reading
“Opioid painkillers cause chronic pain” stories leave physician reader in agony – HealthNewsReview.org – by Stephen Martin, MD, EdM, – June 2016
we have researchers and their accomplices in the news media who trumpet “game-changing” “breakthroughs” on daily basis – often with the flimsiest of scientific support.
The latest example: opioids causing pain
Consider the headlines generated this week by a study which documented a phenomenon known as opioid-induced hyperalgesia. This is the idea that opioid medication, instead of calming pain, might actually make pain worse. Continue reading
Conflating Chronic Pain Management and Opioid Abuse Potential by Charles E. Argoff, MD – April 14, 2017
Appropriate, meaningful, and compassionate treatment options for tens of millions of Americans with persistent chronic pain have come under significant scrutiny in the past few years in the face of our nation’s deepening concerns with rising opioid abuse rates.
As a physician who is American Board of Medical Specialties certified in neurology and in pain management, I focus on prescribing safe, responsible, and effective treatments for people who are experiencing severe chronic pain.
In that context, I am increasingly concerned that policymakers and prescribers are conflating two different and critically important issues. Continue reading
Observations presented to the National Center for Injury Prevention and Control’s Board of Scientific Counselors on behalf of the Opioid Guideline Workgroup – May 2016
This presentation covers many of the problems pain patients and pain doctors have been trying to point out.
Update @11am 4/22/2017: I had thought that our concerns may be reaching the awareness of the CDC, but Richard Lawhern pointed out that this document is from May 2016, just 2 months after the final version of the CDC opioid guideline was released.
It seems to list our concerns merely as issues to be overcome by the “implementation” of the guidelines, which shows they knew all along that the guidelines would be “implemented” as rules for pain patients.
Below, I have extracted the text from the slides of the presentation: Continue reading