{"id":53,"date":"2006-11-27T15:33:13","date_gmt":"2006-11-27T14:33:13","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2006\/11\/27\/jama-2229-nov-2006\/"},"modified":"2006-11-27T15:33:13","modified_gmt":"2006-11-27T14:33:13","slug":"jama-2229-nov-2006","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2006\/11\/27\/jama-2229-nov-2006\/","title":{"rendered":"JAMA 22\/29 Nov 2006"},"content":{"rendered":"<p>The <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2441\">Spine Patient Outcomes Research Trial<\/a> (SPORT) tried to randomise patients with <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2441\">disc herniation and radicular signs<\/a> to receive either <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2441\">open discectomy or non-operative treatment<\/a>. But the referee couldn\u2019t keep control, and players kept changing sides and leaving before full time \u2013fun to watch if you like that sort of thing. <!--more-->Patients in the non-operative group kept insisting on surgery, and a lot were lost to follow-up. Drawing any conclusions from this study is like trying to boil an egg that someone has dropped on the floor. For some reason, <em>JAMA <\/em>decided to publish it, not just in one report but actually two (see <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2451\">here<\/a>), plus an <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2483\">editorial<\/a> making sport of the shortcomings of surgical trials.<\/p>\n<p>This <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2460\">study <\/a>was conducted at the Onze Lieve Vrouwe Gasthuis, Amsterdam. It\u2019s possible that you think a Gasthuis in Amsterdam means a place where teenage boys go to smoke joints and watch dubious films on the television, but they would get a nasty shock at this one, since <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2460\">cardiothoracic surgery<\/a> is performed on all the guests. Moreover, on arrival they are told to swish their mouths with <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2460\">chlorhexidine gluconate<\/a> and snort a nasal ointment containing the same. This reduces <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/full\/296\/20\/2460\">postoperative infection<\/a> after cardiac surgery; but many complain that the only trip they get is this well scary room with lots of lights and instruments, and the nurses keep their clothes on.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The Spine Patient Outcomes Research Trial (SPORT) tried to randomise patients with disc herniation and radicular signs to receive either open discectomy or non-operative treatment. But the referee couldn\u2019t keep control, and players kept changing sides and leaving before full time \u2013fun to watch if you like that sort of thing. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/bmj\/2006\/11\/27\/jama-2229-nov-2006\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[111],"tags":[],"class_list":["post-53","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"jetpack_featured_media_url":"https:\/\/stg-blogs.bmj.com\/bmj\/files\/2017\/02\/richard-lehman.jpg","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/53","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=53"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/53\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media\/38363"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=53"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=53"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=53"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}