A new report analyzing the drugs involved in fatal overdoses once again emphasized fentanyl’s role in the United States’ opioid crisis and highlighted a point frequently made by public health experts:
Most people who fatally overdose
have more than one drug in their system.
In 2016, about 70 percent of fatal overdoses involving fentanyl or heroin involved another drug as well, and roughly 74 percent of fatal overdoses involving cocaine also involved one or more other drugs. Continue reading
Today’s Drug Abusers Did Not Derive From Yesterday’s Patients – By Jeffrey A. Singer – December 4, 2018
We learned last week that the 2017 drug overdose numbers reported by the US Centers for Disease Control and Prevention clearly show most opioid-related deaths are due to illicit fentanyl and heroin, while deaths due to prescription opioids have stabilized, continuing a steady trend for the past several years.
But the media and policymakers remain unshakably committed to the idea that the overdose crisis is the product of greedy pharmaceutical companies manipulating gullible and poorly-trained doctors into over-prescribing opioids for patients in pain and ensnaring them in the nightmare of addiction. Continue reading
Chronic Pain Patients Did Not Cause Opioid Epidemic – by Roger Chriss – May 2017 (Re-post)
By carefully cross-checking the numbers, Mr. Chriss proves it impossible to find patients responsible for the “illicit opioid crisis”.
Contrary to common belief, chronic pain patients are not all opioid addicts and did not cause the opioid crisis. The vast majority of patients who are prescribed opioids rarely misuse or abuse them.
Opioid addiction is real and should not be ignored or downplayed, but we need to identify its true causes. Despite the growing number of restrictions on prescription opioids, overdoses and related deaths continue to rise, which strongly indicates that pain patients have very little to do with the so-called epidemic. Continue reading
This is a humerous slide presentation (with Dilbert!) about the malfeasance we must endure in so much of “scientific” research lately, especially when the results must be forced to support the predetermined “idea” about the study (as explained in my recent post: Statisticians Asked to Commit Scientific Fraud).
Here’s just a quick list of some of the shenanigans he covers:
- Mislead with poor analysis,
- Mislead with averages,
- Mislead with poor graphical displays
- Mislead using chart adjustments
- Mislead using bar charts
I highly recommend you give it a look: How to lie, cheat, manipulate, and mislead using statistics and graphical displays
Here is the verbatim abstract of a sad truth about the corruption of scientific research by, what else, money.
The previous post, Statisticians Asked to Commit Scientific Fraud, discussed the results in more detail and I’m showing this is mainly as a reference. If anyone has access to the full paper, I’d love to see it.
Inappropriate analysis and reporting of biomedical research remain a problem despite advances in statistical methods and efforts to educate researchers. Continue reading
1 in 4 Statisticians Say They Were Asked to Commit Scientific Fraud – By Alex Berezow — October 30, 2018
This article definitely points toward a sad truth, but the sample of 390/522 statisticians from whom they “received sufficient responses” doesn’t look like a representative sample at all.
Only someone who’s been in this situation themselves would answer a survey about “inappropriate requests”. For those who haven’t, they would only check some box saying “it hasn’t happened to me” and then the rest of the survey would be pointless to fill out because it wouldn’t apply to them.
Without access to a full explanation of how they picked their sample, I wouldn’t quote these results. However… Continue reading
Uncritical Publication of a Biased Study Leads to Misleading Media Reports | Pain Medicine | Oxford Academic – Lynn R Webster, MD – 20 November 2018
Dr. Webster points out how much harm is done when sloppy and biased research results are handed to reporters, often with a dramatic positive spin.
On March 6, 2018, (JAMA) published a manuscript titled “Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial,” by Krebs et al. …results of the study led to headlines in major news outlets touting proof that opioids were not for chronic noncancer pain. [Ironically, “Krebs Study” Shows Opioids are Safe]
The article is in the top 5% of all research outputs measured by Altmetric: As of this writing, 313 news stories from 191 outlets, 2 278 tweeters, 45 Facebook pages, nine blogs, and seven Redditors have reported on the study. [See Popular Article on Opioids is Misleading] Continue reading
A tweet from one of our champions for pain patient access to opioids, Dr. Stefan Kertesz (@StefanKertesz) identifies major problems in a study supposedly showing that prescription deaths decreased in states where PDMP was instituted:
Teater: Opioid problem biggest healthcare issue facing America [???]- Nov 2018 – utter nonsense!
The Cleveland Daily Banner has an article with Don Teater, MD, explaining how opioids should never be used for anything other than severe trauma or end-of-life care.
There are glaring errors in every paragraph.
Examples: Continue reading
Automating clinical decisions with predictive analytics – Twitter discussion from Terri A Lewis, PhD @tal7291
This is Dr. Lewis’ take on how Appriss is using the electronic health record (EHR) of pain patients to automatically calculate an “opioid risk score” and guide the doctor to prescribe less and/or add a naloxone prescription. (see EHR tool to assess patient risks for opioid abuse)
This kind of automated standardization flies in the face of the supposed intention to individualize treatments. Unfortunately, such personalized care is expensive, while standardization is cheap.
Allow me to point out the obvious. Med records are far too inconsistent, messy, wrong, incomplete for this to be a valid, reliable tool upon which to make clinical decisions that involve predictive analytics. JUST SAY NO. Continue reading