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Evidence‐Based Medicine and Clinical Trials in Pain Practice and Orthopedics
Author(s) -
Gerdesmeyer Ludger,
Gollwitzer Hans,
Diehl Peter,
Wagner Klaus
Publication year - 2005
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/j.1533-2500.2005.00031.x
Subject(s) - medicine , evidence based medicine , alternative medicine , clinical trial , randomized controlled trial , clinical practice , medline , scientific evidence , physical therapy , orthopedic surgery , medical literature , intensive care medicine , medical physics , surgery , pathology , philosophy , epistemology , political science , law
Medical practices should be based on scientific findings pursuant to the rules of evidence‐based medicine. Quality standards for interventional pain therapy and orthopedic clinical studies have been lacking. As a result, the efficacy of many forms of therapy is insufficiently documented, making the level of evidence low. This article identifies common deficiencies in the conduct of clinical trials, as well as limitations in conducting randomized controlled studies. Recommendations for improvement are provided. The discussion provides the clinically active physician with interpretation aids for the evaluation of meta‐analyses, supports personal evidence‐based decisions, and reviews the most important principles for planning and conducting of experimental clinical studies. Current examples in the literature verify the implementation of these principles and present current findings in accordance with evidence‐based medicine (EBM) criteria. In spite of an increasing emergence of EBM‐based studies, we conclude that the number of well‐designed, high quality, controlled studies conducted in accordance with the guidelines of Good Clinical Practice examining interventional pain therapy and orthopedic clinical studies remains unacceptably low.