Misplaced Pages

Revision as of 18:11, 23 August 2009

Medicine Start‑class Mid‑importance

This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Misplaced Pages talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine Start This article has been rated as Start-class on Misplaced Pages's content assessment scale. Mid This article has been rated as Mid-importance on the project's importance scale.

There is more than one reader of NEJM on Misplaced Pages.  :-) Keith Henson (talk) 03:24, 6 August 2009 (UTC)

I removed the part stating that some physicians disagreed with the NEJM articles because the control patients did not receive a facet injection (in any case there is no agreement that facet injections help anyone), the section implied that the trivial difference in pain score could be meaningful but the difference did not even approach statistical significance, and a reference citing a press release issued by a group of private physicians is a weak counter to material that cites the NEJM. CrunchyChewy (talk) 16:06, 7 August 2009 (UTC)

After the last edit, the article seemed to suggest that vertebroplasties had been discredited or proven ineffective--which is certainly not the case. There are a variety of smaller studies in medicine that have been refuted in larger clinical trials. An entire past-proven pain treatment modality should not be discredited by two small trials. Instead, this should prompt further investigation into the discrepancies of these recently published trials with the mass amount of previous literature indicating substantial benefit of vertebroplasty.

I added some additional information to the research section, citing several larger studies that demonstrate vertebroplasty as an effective and clinically proven procedure for treating VCF's. I also added some details to the procedure section. Last, I created a Risks section, summarizing the potential risks associated with the procedure.

MarkEgge (talk) 16:50, 7 August 2009 (MST)

CrunchyChewy, I too swore an oath to evidence-based medicine. But Misplaced Pages follows WP:NPOV and there are doctors out there who still believe on the basis of their first-hand experiences that vertebroplasty works.

Double-blind studies are the gold standard in medicine - this fact is not my personal opinion. There are no perfect studies, but two separate double-blind randomized controlled studies (the only two ever done for this procedure) have come to the same conclusion. Some pretty extraordinary flaws will need to discovered within these studies before the conclusion of case studies (no matter how numerous) supersedes the conclusions of double-blind randomized controlled studies.CrunchyChewy (talk) 18:11, 23 August 2009 (UTC)

We can't just delete opinions that are wrong. We should explain why this apparent success isn't real. And there is no such thing as a perfect double-blind study. Some patients crossed over. So there are flaws or at least limitations in the study. The NEJM authors didn't say we shouldn't do vertebroplasties any more, they said we should only do them in well-designed investigational studies.

There were some good newspaper stories which covered this debate among doctors pretty well. I'll be reading them more carefully today.

And if you have to suffer with the American political system, you know that some of the industry-funded political groups are using this as an example of how the government will take away their free choice in health care. --Nbauman (talk) 16:02, 9 August 2009 (UTC)

• Start-Class medicine articles
• Mid-importance medicine articles
• All WikiProject Medicine pages