Placebo effects are weak: regression to the mean is the main reason ineffective treatments appear to work
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“Statistical regression to the mean predicts that patients selected for abnormalcy will, on the average, tend to improve. We argue that most improvements attributed to the placebo effect are actually instances of statistical regression.”
“Thus, we urge caution in interpreting patient improvements as causal effects of our actions and should avoid the conceit of assuming that our personal presence has strong healing powers.”
McDonald et al., (1983)
In 1955, Henry Beecher published "The Powerful Placebo". I was in my second undergraduate year when it appeared. An...
Source: DC's goodscience - December 11, 2015 Category: Science Authors: David Colquhoun Tags: acupuncture CAM placebo publishing quackademia random randomisation randomization RCT regression to the mean reproducibility statistics alternative medicine chiropractic osteopathy physiotherapy placebo effect Source Type: blogs
Candy’s Wheat Belly transformation
Candy shared her impressive evolving benefits living the Wheat Belly lifestyle:
“I feel better and have much less inflammation. I’ve suffered from constant low back pain and have taken ibuprofen daily for years, but recently have stopped taking it and feel good.
“I’ve also noticed positive changes in my skin, smaller pores and smoother skin, especially on my face and chest. Also many of the small red spider veins on my lower legs and feet have diminished. See the difference in the photos. I also feel younger, and if I don’t say so myself, look younger.
“I am excited about the positive c...
Source: Wheat Belly Blog - December 5, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories anti-aging facial change gluten grains Inflammation low back pain spider veins varicose varicositites Weight Loss Source Type: blogs
Understanding " Disaster Reactions "
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Source: Dr. Deborah Serani - November 14, 2015 Category: Psychiatry & Psychology Tags: anxiety depression mental health trauma Source Type: blogs
Managing Sacroiliac Pain in the Emergency Department
I have been treating specifically localized sacroiliac pain with injections of bupivacaine and methylprednisolone for several years. It seems that every few months I have a patient who presents with localized pain and can benefit from this procedure. The only patients on whom I perform these injections are those who localize their pain to the back dimples, also known as the dimples of Venus or fossae lumbales laterales.
Anatomically, it is known that beneath these dimples are the superior aspects of the sacroiliac joints. These sacral sulci are anatomically just above the posterior superior iliac spine and also the junc...
Source: M2E Too! Mellick's Multimedia EduBlog - November 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Managing Sacroiliac Pain in the Emergency Department
I have been treating specifically localized sacroiliac pain with injections of bupivacaine and methylprednisolone for several years. It seems that every few months I have a patient who presents with localized pain and can benefit from this procedure. The only patients on whom I perform these injections are those who localize their pain to the back dimples, also known as the dimples of Venus or fossae lumbales laterales.
Anatomically, it is known that beneath these dimples are the superior aspects of the sacroiliac joints. These sacral sulci are anatomically just above the posterior superior iliac spine and also the ju...
Source: M2E Too! Mellick's Multimedia EduBlog - November 2, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Research & Reviews in the Fastlane 106
This study investigated the use of apneic oxygenation in the ICU. The researchers found no difference in the lowest O2 sat. However, it’s unclear if this study is applicable to the ED setting and it likely does not reflect our standard management (33% had BPAP during apnea, 40% had BVM during apnea). For now, collective anecdotes of efficacy reign while we await research in the ED setting.
The authors conclusion is that apneic oxygenation does not appear to increase lowest arterial oxygen saturation during endotracheal intubation of critically ill patients compared to usual care. Although this is the first randomized...
Source: Life in the Fast Lane - October 28, 2015 Category: Emergency Medicine Authors: Jeremy Fried Tags: Airway Cardiology Clinical Research ECG Education Emergency Medicine Intensive Care Pediatrics Public Health R&R in the FASTLANE critical care EBM literature recommendations research and reviews Source Type: blogs
The Payment Reform Landscape: Which Quality Measures Matter?
Over the past 15 years there have been major changes in the measures we have at our disposal to assess the quality of care. We have gone from decentralized disorganization to measures that have been “standardized” through various multi-stakeholder consensus processes, including that of the National Quality Forum. And where there was a dearth of standard quality measures, some now argue we have too many (600-plus and counting), but not the right ones.
This has led to initiatives like the Measure Applications Partnership, the Institute of Medicine’s report “Vital Signs: Core Metrics for Health and Health Care Progres...
Source: Health Affairs Blog - October 15, 2015 Category: Health Management Authors: Suzanne Delbanco, François de Brantes and Tom Valuck Tags: Costs and Spending Featured Insurance and Coverage Organization and Delivery Payment Policy Quality AHIP Core Measures Collaborative employers IOM report National Quality Forum Payment Reform Landscape quality measures Suzanne Delb Source Type: blogs
Education Positively Impacts Safe Opioid Prescribing Among Clinicians
A recent study in the journal Pain Medicine, looking at the impact of continuing medical education (CME) on opioid prescribing found that educating clinicians on how to safely prescribe opioids can help decrease misuse among chronic pain sufferers.
While untreated or under-treated chronic pain causes reduced function and quality of life, including increased risks of suicide, more aggressive chronic pain management with opioid analgesics has been associated with an increase in prescription opioid misuse including addiction and overdose deaths. Due to the high prevalence of prescription opioid misuse, the ...
Source: Policy and Medicine - September 4, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
PCORI is Starting to Click. Give It a Chance.
By STEVE FINDLAY
Earlier this month the Center for Public Integrity (CPI) published a sharp-edged piece on PCORI—the Patient-Centered Outcomes Research Institute.
The piece raised some salient issues and it’s timely to take stock of PCORI at the half way point of its authorized funding. (Unless renewed, PCORI sunsets in 2019.)
The Affordable Care Act created PCORI as an independent nonprofit (non-government) entity. But PCORI’s funding and structure makes it more or less quasi-government. It gets its money from the Medicare trust fund, treasury general funds, and a tax on private insurers and self-funded i...
Source: The Health Care Blog - August 26, 2015 Category: Consumer Health News Authors: John Irvine Tags: THCB Source Type: blogs
Eliminate AHRQ?
I don't know how I missed this but it seems the current version of the budget for the Department of Health and Human Services currently making its way through congress totally eliminates the Agency for Healthcare Research and Quality. This is as deep as the Republicans have ever sunk into yahooism.As Jeffrey Lerner explains:AHRQ funds the studies and systematic reviews that objectively evaluate how well clinical procedures, quality approaches, and consumer satisfaction work. But AHRQ's approximately $400 million annual budget does more than pay for studies. It helps fund what has been the missing link of American healt...
Source: Stayin' Alive - August 11, 2015 Category: American Health Source Type: blogs
No grains, no pain for Ali
Ali suffered from a variety of chronic pains. You can almost see the pain in her eyes: bags under the eyes, around-the-eye puffiness, edematous cheeks.
She shared her two week–TWO WEEK–experience starting the inflammation-reversing, edema-reversing, pain-reversing, and age-reversing Wheat Belly lifestyle:
“Here is my two week before and after. I see a big difference in the eye area and I’m feeling so much better. No more lower back pain and no more burning in my upper back and shoulder area. I’m so glad I have stuck with it this time.
“It’s so nice to not be in pain!”
I bel...
Source: Wheat Belly Blog - July 27, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Success Stories facial change gluten grains Inflammation joint pain Source Type: blogs
To Reduce Unnecessary Care, Choosing Wisely Moves from Awareness to Implementation
In 2012 the ABIM Foundation launched the Choosing Wisely campaign with the goal of kick-starting an important and needed national conversation about unnecessary health care tests and procedures. A pervasive and persistent problem in our health care system, unnecessary care was estimated by the Institute of Medicine to amount to $750 billion a year—roughly 30 percent of health care spending—and was projected to keep growing.
Since then, Choosing Wisely has grown precipitously, adding more than 100 new partners and evolving its approach to make a lasting impact. Most recently, through the support of grants from the Rober...
Source: Health Affairs Blog - July 1, 2015 Category: Health Management Authors: Daniel Wolfson and Susan Mende Tags: Costs and Spending Drugs and Medical Technology GrantWatch Health Professionals Quality Choosing Wisely Consumers Effectiveness Health Philanthropy Physicians Source Type: blogs
Patient-centered research can improve chronic pain care and address opioid abuse
Going for the Brass RingLast year, Joe Selby, MD, executive director of the Patient-Centered Outcomes Research Institute (PCORI), spoke to members of the NIH Interagency Pain Research Coordinating Committee (PCORI) to inform those of us on the committee about PCORI’s intentions to do more funding focused on chronic pain research. Dr. Selby said their interests were possibly in low back pain, migraine, musculoskeletal pain, and/or opioid abuse. I was elated. Then about a month ago (May 14, 2015), Dr. Selby posted a blog on the PCORI website titled, “Patient-Centered Research Can Improve Chronic Pain Care and Add...
Source: blog.bioethics.net - June 26, 2015 Category: Medical Ethics Authors: Practical Bioethics Tags: Health Care syndicated Source Type: blogs
Platelet Rich Plasma PRP Therapy in Sarasota Florida for Joint and Foot Pain
Platelet Rich Plasma PRP Therapy in Sarasota Fl for Joint and Foot Pain
Patients are being treated currently at Sarasota Neurology with PRP (platelet rich plasma) for a wide variety of joint pain and other pain issues. Among the more common uses for PRP are knee pain, shoulder pain and other painful conditions such as plantar fasciitis, tennis elbow, some types of low back pain. PRP can also be used in patients that have residual joint pain from having had orthopedic arthroscopic knee or shoulder surgery.
PRP works to heal painful joints by using the patients’ own natural healing mechanism. The injured or damaged ti...
Source: Sarasota Neurology - May 28, 2015 Category: Neurology Authors: Dan Kassicieh, D.O. Tags: Back Pain Platelet Rich Plasma foot pain natural healing foot pain plantar fasciitis platelet rich plasma therapy sarasota florida prp sarasota florida Source Type: blogs
