Comparative Effectiveness: Back Surgery Remains Popular Despite Poor Study Results
Main Category: Back PainAlso Included In: Health Insurance / Medical Insurance
Article Date: 25 Aug 2009 - 3:00 PDT
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Studies have recently found that vertebroplasty - a type of back surgery in which cement is injected into the spine - isn't effective, but many patients and their doctors insist it works. The surgery "is under scrutiny after two recent studies in the New England Journal of Medicine concluded the popular treatment to ease pain from back fractures, typically caused by osteoporosis, is no more effective than a sham surgery," The Boston Globe reports. "Coming more than a decade after vertebroplasty was introduced in this country, the studies are the first to compare the treatment's effectiveness to a placebo surgery, the gold standard for medical research."
"Yet the findings are unlikely to change the practice of many specialists, who said they don't jibe with their years of experience" providing pain relief to patients. "The fallout illustrates how hard it is to find clear-cut answers about whether health care dollars are being wisely spent, a key question as Congress debates a national overhaul of the health care system. President Obama has promoted such 'comparative effectiveness research' as a way to cut costs and improve quality."
"The studies' tsunami-like aftershocks -- insurers are now reconsidering whether they will continue to pay for the treatment -- also underscore a little-known fact outside the medical community: Surgeries often become widespread before they've undergone rigorous evaluation. While prescription drugs and medical devices must be reviewed by federal regulators before they're released to the public, surgical procedures do not" (Lazar, 8/24).
This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.
© Henry J. Kaiser Family Foundation. All rights reserved.
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MLA
25 May. 2012. <http://www.medicalnewstoday.com/releases/161739.php>
APA
http://www.medicalnewstoday.com/releases/161739.php.
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Visitor Opinions (latest shown first)
Well-noted Pain Physicians Question Validity Of Study, Not Procedure
posted by Mallory Simons on 10 Sep 2009 at 5:01 amPress Releases from well-noted pain physicians questioning the validity of the study, not the procedure:
"The conclusion that vertebroplasty does not help back pain is completely wrong. If you look closeley at the study design, what they are calling a placedbo is actually a facet injection." -Allen Burton, MD: Professor of Anesthesiology at MD Anderson in Houston
"The trends in the data demonstrate that if the studies had enough patients, the group receiving vertebroplasty would have had significantly better pain reduction than the other treatment groups." -Paul Lynch: Assistant Professor at Mayo Clinic College of Medicine and co-founder of Arizona Pain Specialists
"...4 times as many patients-or 43 %- who had the control treatment crossed over to have vertebroplasty performed, compared to 12 percent of vertebroplasty patients who switched. A 12 % dissatisfaction with vertebroplasty is in line with the many studies that have shown clinical success rates of 80-90 % pain relief following vertebroplasty...
This is important because the trends in the data show that if the study had enough patients, the group receiving vertebroplasty could have demonstrated a clinically meaningful improvement in pain. It is therefore surprising that a study that was showing a trend twoard statistical significance was terminated early with only half the number of patients recruited. A huge doubt now remains as to whether a study with the original intended group size would have yielded a different outcome." -Mubin I. Syed: co-founder of Dayton Interventional Radiology
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