Hoffman's glasses: evidence-based medicine and the search for quality in the literature of interventional pain medicine

Merrill, Douglas G.

doi:10.1016/s1098-7339(03)00234-7

Cited by 23 publications

(21 citation statements)

References 83 publications

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“…Finally, several authors have argued that IPM needs to endorse a BPSM of pain and integrate its practice within a multidisciplinary framework [22,26,38,41]. The clinical advantages of the application of pain procedures within a larger clinical context of multidisciplinary care would seem obvious, including the opportunity for interventional pain practitioners to have direct consultation with pain psychologists when evaluating candidates for pain procedures as well as rendering pain services within a therapeutic context that concurrently addresses comorbidities of suffering and disability.…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…There has been longstanding and continued controversy surrounding the efficacy of IPM for the long-term management of chronic pain [21,22]. Numerous critical reviews have failed to find evidenced-based support for the routine use of IPM [10,[21][22][23] as well as for specific procedures such as epidural steroid injections [24][25][26][27] and facet blocks [28,29] for the management of chronic spinal pain. Routine administration of nerve blocks for chronic pain is further challenged by studies of healthy and clinical populations that find little association between abnormalities on magnetic resonance imaging or computerized tomography, upon which much of the decisionmaking for IPM relies, and pain experience [30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

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Interventional pain medicine: retreat from the biopsychosocial model of pain

Roth

Geisser

Williams

2011

Behav. Med. Pract. Policy Res.

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The field of pain medicine has shifted from multidisciplinary rehabilitation to procedure-focused interventional pain medicine (IPM). Considerable controversy exists regarding the efficacy of IPM and its more narrow focus on nociception as an exclusive target of pain treatment. This topical review aims to examine pain research and treatment outcome studies that support a biopsychosocial model of pain, and to critique the clinical practice of IPM given its departure from the premises of a biopsychosocial model. A modern definition of pain and findings from clinical and basic science studies indicate that pain-related psychological factors are integral to pain perception. The clinical viability of IPM is challenged based upon its biomedical view of peripheral nociception as a primary source of pain and the potential of this viewpoint to foster maladaptive pain attributions and discourage the use of pain coping strategies among chronic pain patients. IPM should adopt a biopsychosocial perspective on pain and operate within a framework of multidisciplinary pain rehabilitation to improve its effectiveness. KEYWORDS

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Interventional pain medicine: retreat from the biopsychosocial model of pain

Roth

Geisser

Williams

2011

Behav. Med. Pract. Policy Res.

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“…Fifteen of those trials report on radiofrequency (RF) procedures performed at several levels, and spinal cord stimulation was documented in 7 prospective randomized trials for the management of cardiac pain, complex regional pain syndrome, referred vascular pain, and failed back surgery syndrome. 1 Moreover, most of the randomized controlled trials (RCTs) in interventional pain management techniques have methodological weaknesses. In 43 studies the intervention to be assessed was not tested against the "best medical treatment."…”

Section: Introductionmentioning

confidence: 99%

Radiofrequency and Pulsed Radiofrequency Treatment of Chronic Pain Syndromes: The Available Evidence

Boxem

Eerd²,

Brinkhuize³

et al. 2008

Pain Practice

107

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There are currently 6 reviews on (pulsed) radiofrequency (RF) for the management of spinal pain. Two reviews on interventional pain management techniques in general also discuss RF. The outcomes of those reviews depend on the type of studies included and the opinion of the reviewers, which may result in different evidence levels. Radiofrequency denervation at the cervical and lumbar level has produced the most solid evidence. The differences in treatment outcome registered in the 5 randomized controlled trials (RCTs) regarding lumbar facet denervation can be attributed to differences in patient selection and/or inappropriate technique. There is not sufficient evidence supporting the use of RF facet denervation for the management of cervicogenic headache. The studies examining the management of cervical radicular pain suggest a comparable efficacy for RF and pulsed RF (PRF). The PRF treatment is supposed to be safer and therefore should be preferred. The superiority of RF treatment adjacent to the lumbar dorsal root ganglion for the management of lumbar radicular pain has not been demonstrated in an RCT. Information regarding RF treatment of sacroiliac joint pain is accumulating. No randomized sham-controlled trials on the value of RF treatment of the Gasserian ganglion for the management of idiopathic trigeminal neuralgia have been published. One RCT indicates superiority of RF over PRF for the management of idiopathic trigeminal neuralgia. Future research to confirm or deny the efficacy of (P)RF should be conducted in carefully selected patient populations. The tests used for patient inclusion in such a trial could potentially help the clinician in selecting patients for this type of treatment. The value of PRF treatment of the peripheral nerves also needs to be confirmed in well-designed trials.

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“…4 The 218 retrieved trials on cancer pain (of 24,000 screened) employed 125 different pain assessment instruments! Similar problems related to low quality, heterogeneous primary trials of interventional pain management have been noted by Merrill 62 and their implications commented upon. 63 The inexorable increase in numbers of assessment instruments has been paralleled by concurrent increases in the numbers of systems to rate the strength of scientific evidence such as RCTs, observational studies, and systematic reviews.…”

Section: But Pain-related Evidence Is Rarely Elegantmentioning

confidence: 59%

When Bad Evidence Happens to Good Treatments

Carr¹

2008

Regional Anesthesia and Pain Medicine

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Hoffman's glasses: evidence-based medicine and the search for quality in the literature of interventional pain medicine

Cited by 23 publications

References 83 publications

Interventional pain medicine: retreat from the biopsychosocial model of pain

Interventional pain medicine: retreat from the biopsychosocial model of pain

Radiofrequency and Pulsed Radiofrequency Treatment of Chronic Pain Syndromes: The Available Evidence

When Bad Evidence Happens to Good Treatments

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