This piece has also been stimulated by a publication in JAMA, this time evaluating the use of denervation of joints in spinal pain.[1] It is a set of three large (n=251, n=228, n=202), probably definitive, pragmatic trials that evaluate the use of radiofrequency denervation (RFD) as an addition to a 3 month standardised exercise […]
Category: NICE
Too NICE – there appears to be a glaring orthodox bias in NG59
When the draft clinical guideline for low back pain & sciatica was published in February 2016, it was with some resignation that I noted the 2009 recommendation in CG88 for acupuncture in low back pain (from 6 weeks to 1 year)[1] had been dropped. It was expected for a variety of off-radar reasons, from pre-guideline […]
Musings on heterogeneity in quantitative outcomes of acupuncture trials in LBP
Further commentary: Low back pain and sciatica: management of non-specific low back pain and sciatica Draft clinical guideline February 2016 This commentary follows a previous blog post. Late last Friday night I got around to dropping the pain VAS outcome figures from the trials of acupuncture versus sham into RevMan 5 – the software used for […]
Exercise not acupuncture recommended by NICE for low back pain – balanced assessment, bias or error?
Commentary: Low back pain and sciatica: management of non-specific low back pain and sciatica Draft clinical guideline February 2016 NICE clinical guidelines are very large pieces of work. This draft runs to over 1000 pages with the addition of around 2500 pages of appendices, and data extracted and analysed from nearly 600 RCTs. Having sat on […]