Health Sciences 3840A/B Lecture Notes - Lecture 2: Randomized Controlled Trial, Spinal Fusion, Percutaneous Vertebroplasty
7 Jan 2020
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Food and drug administration does not regulate surgery like it does drugs. Expectation is that medical practice will change if an operation turns out not to help: not the case, the onus is on the patient to ask what evidence shows that a surgery is better than another option. 2012 insurance company said it would no longer pay for the spinal fusion surgery and other insurers followed suit: financial disincentives lowered the rate of the surgery, clinical trials couldn"t do this. Vertebroplasty operation was compared to a sham procedure in a clinical trial and found that it had no benefit: pain relief was the same in both groups, yet the surgery continued to be performed. Surgeries thought to continue because the insurers keep paying doctors and doctors remember their own patients who seemed to feel better afterward: mean age of the study wasn"t reflective of the patient population.
