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BackPage Online, September 2017

doi: 10.1097/01.BACK.0000524488.75794.6b
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The Hazards of Believing Small, Underpowered Studies

A commentary at the health journalism site HealthNewsReview.org points out the hazards of lending credence to the types of small, underpowered studies that are often discussed at medical conferences, featured in second-line journals, and touted in the mass media. Kathlyn Stone describes the distortions that small studies can bring: they may conceal safety issues, exaggerate treatment effects, and lead to unethical use of misleading information. Here is a link to the full article:

https://www.healthnewsreview.org/2017/07/small-studies-be-vigilant-when-writing-about-them-and-skeptical-when-reading-about-them/

Healthcare Reformers Often Target Fusion Surgery as Therapeutic Excess. But Other Common Orthopedic Procedures Are Drawing Similar Criticisms

Excessive spine care is a major problem in the United States, resulting in billions of dollars of unnecessary spending every year. The spine surgery area is often targeted as an example of wasteful care. And indeed there has been an excessive run-up in fusion surgery rates over the past two decades—particularly for vague, controversial indications such as “degenerative disc disease.” But reformers are also targeting other areas of orthopedic surgery. Here is a critique of unnecessary arthroscopic knee surgery procedures from Aaron Carroll, MD, of the Incidental Economist. This kind of scrutiny is important—across medical fields.

See http://theincidentaleconomist.com/wordpress/healthcare-triage-news-knee-surgery-doesnt-improve-outcomes-but-we-still-do-a-lot-of-them/

Are More Drugs and Devices the Solution for the Opioid Crisis? Not Likely...

Francis Collins, MD, PhD, director of the National Institutes of Health, recently proposed addressing the opioid crisis with a wave of research on new drugs and devices to relieve pain and combat addiction. This strategy has come under bitter criticism from opioid researchers, clinicians, and other observers for being short-sighted and unrealistic. A commentary at the website of the Lown Institute points out that the opioid crisis won't be resolved with new medications and other programs from the pharmaceutical industry. This is a crisis with strong socioeconomic and cultural underpinnings—in society-at-large and in the medical system—and it can only be addressed with broad holistic solutions. Here is the article from the Lown Institute, containing links to other interesting resources:

http://lowninstitute.org/news/nihs-solution-opioid-crisis-drugs/

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