Double Blind Controlled Trials - Where are they?
Posted: Tue Mar 22, 2011 2:18 pm
Firstly I thought I would post up this video which clearly explains how Double Blind Controlled Trials are performed.
http://www.youtube.com/watch?v=aSP2OMiFxhg
I have been looking for Double Blind Controlled Trials for the two main treatments discussed on this forum - Physical therapy and PNE surgery. I can not find a single one.
I appreciate it is almost impossible to perform a blinded study for both of these treatments so I decided to look for just randomized studies. I can find two.
One of these was for myofascial physical therapy which was compared to a regular full body massage. This study was performed on IC patients. This study demonstrated that for the symptom of pain ( measured on a scale of 1-10 ) myofascial therapy did not have a significantly greater effect than a regular massage. The drop in pain levels was small. A trial study from this same team on prostatitis patients yielded similar results.
The second study was for the TG PNE surgery performed by the Nantes team which compared this surgery with a non surgery group. This study did show the validity of the surgery - ''At 12 months, 71.4% of the surgery group compared with 13.3% of the non-surgery group were improved''. Although only half of the surgery sample sustained their improvement after 4 years and the non surgery group were not followed up at the 4 year point to compare. So this study is not a great endorsement for the surgery they are performing.
It seems that this illness involves us as patients having to experiment with treatments for which there is little or no evidence for. We are faced with a desert of evidence based treatments.
The strange paradox is that I have been to see practitioners who have claimed tremendous success rates. I have seen PT's who claim they have a 90% or 80% cure rate. A PNE neurosurgeon in L.A makes a claim of an 87% success rate. When practitioners lay claim to such extraordinary success rates we as patients should apply more pressure for such practitioners to back up these claims with well designed studies.
http://www.youtube.com/watch?v=aSP2OMiFxhg
I have been looking for Double Blind Controlled Trials for the two main treatments discussed on this forum - Physical therapy and PNE surgery. I can not find a single one.
I appreciate it is almost impossible to perform a blinded study for both of these treatments so I decided to look for just randomized studies. I can find two.
One of these was for myofascial physical therapy which was compared to a regular full body massage. This study was performed on IC patients. This study demonstrated that for the symptom of pain ( measured on a scale of 1-10 ) myofascial therapy did not have a significantly greater effect than a regular massage. The drop in pain levels was small. A trial study from this same team on prostatitis patients yielded similar results.
The second study was for the TG PNE surgery performed by the Nantes team which compared this surgery with a non surgery group. This study did show the validity of the surgery - ''At 12 months, 71.4% of the surgery group compared with 13.3% of the non-surgery group were improved''. Although only half of the surgery sample sustained their improvement after 4 years and the non surgery group were not followed up at the 4 year point to compare. So this study is not a great endorsement for the surgery they are performing.
It seems that this illness involves us as patients having to experiment with treatments for which there is little or no evidence for. We are faced with a desert of evidence based treatments.
The strange paradox is that I have been to see practitioners who have claimed tremendous success rates. I have seen PT's who claim they have a 90% or 80% cure rate. A PNE neurosurgeon in L.A makes a claim of an 87% success rate. When practitioners lay claim to such extraordinary success rates we as patients should apply more pressure for such practitioners to back up these claims with well designed studies.