Tag Archives: research-bias

Effectiveness and Risks of Long-Term Opioid Tx

The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain. – PubMed – NCBI – Sep 2014

I originally found this in a government-sponsored Research Review, from the Effective Health Care Program (Helping You Make Better Treatment Choices) under the Agency for Healthcare Research and Quality (AHRQ).

But now in 2019, I can’t find it there anymore. I can only find the abstract of what used to be a 219-page report, which had reached the same non-conclusion as all other studies of the last couple of decades: “more research is needed”, used when the study doesn’t find the results they wanted.

I think this increasingly common “conclusion” to studies of opioids is a pathetic evasion of the full truth.  Continue reading

Absurdities Arising from Indiscriminate Use of Research

Breakthrough research reveals parachutes don’t prevent death when jumping from a plane | Association of Health Care Journalistsby Tara Haelle – Feb 2019

The goal of evidence-based medicine (EBM) is to base medical care only on the best evidence: rigorous randomized controlled trials (RCTs). In general, this seems to make sense, but as an overarching objective applied to all cases, it can become absurd.

It’s been 15 years since BMJ published the most rigorous type of study there is — a systematic review of randomized controlled trials — to assess the evidence for using a parachute to prevent death and major injury when jumping from a plane.

They had to conclude, “As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomized controlled trials.”   Continue reading

Most People Don’t Feel Euphoric From Opioids

Most People Don’t Actually Feel Euphoric When They Take Opioids, Study Finds | Live Science –  By Nicoletta Lanese – Oct 2019

Opioids are known to spark feelings of euphoria in users, but does everyone really share the same experience?

Opioids jump-start the brain’s reward system, provoking a burst of pleasurable feelings along with a dizzying drug-induced high. At least that’s what scientists used to think

But mounting research suggests that the average person doesn’t actually reach this euphoric state on opioids, particularly not the first time they try it. In fact, people who are not addicted to opioids may feel subjectively worse after taking the drug, according to cognitive neuroscientist Siri Leknes.    Continue reading

Opioids Continue to Be Effective Long Term

Opioids Continue to Be Effective Long Term Medscape – Fran Lowry – October 01, 2013

This is a good review with results that ring true in my experience,

Unfortunately, it’s fatally tainted by funding from Purdue.

An extensive literature review of studies evaluating the effectiveness of long-term opioid therapy in chronic noncancer pain (CNCP) concludes that the drugs continue to provide reliable and safe analgesia for 6 months or more.

“Due to FDA regulatory guidelines, most contemporary phase 3 randomized controlled trials of opioid analgesics for CNCP are 3 months long or less.   Continue reading

Debunking Myths About Origins of Opioid Abuse

Study Debunks Myths About Origins of Opioid Abuse — Pain News Network  – By Pat Anson, PNN Editor – June 2019

It’s become a popular myth – and for some, a propaganda tool – to claim that opioid pain medication is a gateway drug to heroin and other street drugs.

An opioid education campaign called The Truth About Opioids – funded with taxpayer dollars from the White House Office of National Drug Control Policy — declares in big bold letters on its website that “80% of heroin users started with a prescription painkiller.”

So now our tax dollars are being used to create the lies and propaganda that are driving the restrictions on our pain medication; we are paying for the privilege of being tortured by the withholding of necessary pain medication.  Continue reading

PLOS ONE pulls highly cited mindfulness paper

PLOS ONE pulls highly cited mindfulness paper over undeclared ties, other concerns – by Adam Marcus – Apr 2019

Mindfulness “peaked” a few years ago and has received much less attention lately, perhaps because it has always been a more hyped than proven do-it-yourself “treatment”.

It appeared to help pain patients, but after the first excitement, enthusiasm, and hope for betterment through this DIY treatment fades, the pain is still there for most of us. I find mindfulness to be appropriate in my daily life, to center myself after having been angered or frightened by what I read, but I’ve never experienced any pain relief from it.

PLoS ONE has retracted a meta-analysis on mindfulness after determining that the authors used dubious methodology and failed to adequately report their financial interest in the psychological treatment the article found effective. Continue reading

Opioids: Bad Science, Bad Policy, Bad Outcomes

Opioids: Bad Science, Bad Policy, Bad Outcomes – by Henry I. Miller and Josh Bloom – 2019

 As is so often the case nowadays, this article does not show what date it was published. This is clearly intended to confuse the reader about whether it’s a “current” article or from much older archives.

I can only estimate the date of publication by what other studies it references. In this case, it refers to a JAMA article from Feb 2019, so it must be later than that.

There’s an old joke about the drunk who’s hunting for his lost keys under the lamppost, not because he thinks they’re there, but because the light is good. Well, that’s what the feds and state governments are doing to try to quell the epidemic of opioid addiction and overdoses.    Continue reading

Critical Appraisal of Clinical Research

Critical Appraisal of Clinical Research – Free full-text /PMC5483707/J Clin Diagn Res. May 2017

This article is a primer on how to read research studies: what to look for and what to question.

Evidence-based practice is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and patient’s values and expectations into the decision making process for patient care.

It is a fundamental skill to be able to identify and appraise the best available evidence in order to integrate it with your own clinical experience and patients values.      Continue reading

Strange Correlations with Opiod Use

Inspire.com Opioid Information Thread – User “Seshet” – Aug 2019

This is “Seshet’s” ongoing thread that’s very similar to what I do here: finding and reporting on the latest opioid-related articles. He’s a self-described “math nerd” with a scientific background, so his analysis of these articles is based on hard facts, not sentiments or speculation.

More fascinating research from NIDA. Seems that drug initiation is seasonal.

For more such “spurious correlations” see a previous post of that very name which a list of countless correlations of completely unrelated variables: “Spurious Correlations“.

Less research is needed

Less research is needed | Speaking of Medicine | Plos BlogsPosted June 2012 by Trisha Greenhalgh

The most over-used and under-analyzed statement in the academic vocabulary is surely “more research is needed”. 

This has been bothering me for a while too. I’ll read through an endless extremely detailed study only to find the conclusion is that “more research is needed”. I thought the current study *was* more research, but those last words place all the findings in doubt and show the researchers have no confidence in their results.

These four words, occasionally justified when they appear as the last sentence in a Masters dissertation, are as often to be found as the coda for a mega-trial that consumed the lion’s share of a national research budget, or that of a Cochrane review which began with dozens or even hundreds of primary studies and progressively excluded most of them on the grounds that they were “methodologically flawed”.   Continue reading