CDC Manipulated Data to Deceive
This commentary presents the case that the CDC manipulated the data it used as a basis for its opioid prescribing guidelines.
By imposing an arbitrary non-standard constraint and excluding some studies that were included in earlier reports, the CDC created a different interpretation by using a different set of data.
Objectives. A recent US federal review and clinical guideline on opioids for chronic pain asserted that the literature contributes no evidence on efficacy because all trials had “inadequate duration.”
To explore the evidence, we examined durations of studies on opioid, nonopioid drug, and behavioral therapies for chronic pain.
Methods. We retrieved Cochrane reviews of anticonvulsants, antidepressants, NSAIDs, opioids, or behavioral interventions for chronic pain. We also examined all opioid treatment studies retrieved for the federal evidence report but excluded due to “inadequate duration.”
Results. We graphed numbers of trials vs duration for the five treatments reviewed in the Cochrane Library, compared with durations of opioi12690d trials dropped from the federal evidence report. Most graphs were overdispersed Poisson distributions. Nearly all trials had active treatment durations of 12 weeks or less.
Conclusions.
No common nonopioid treatment for chronic pain has been studied in aggregate over longer intervals of active treatment than opioids.
To dismiss trials as “inadequate” if their observation period is a year or less is inconsistent with current regulatory standards.
The literature on major drug and nondrug treatments for chronic pain reveals similarly shaped distributions across modalities.
Considering only duration of active treatment in efficacy or effectiveness trials, published evidence is no stronger for any major drug category or behavioral therapy than for opioids.
© 2016 American Academy of Pain Medicine.
The full article details how the CDC’s conclusions are based on studies selected by using arbitrary non-standard standards of inclusion/exclusion.
Introduction
The use of opioids began in prehistory and is now standard practice in much of the world for the management of acute, chronic, and cancer-related pain.
Balancing the legitimate medical use of opioids for analgesia vs society-wide abuse, misuse, diversion, addiction, and mortality has become a major public health theme.
In March 2016, the US Centers for Disease Control and Prevention (CDC) published a guideline for prescribing opioids for chronic pain on the CDC website.
An important message communicated in the CDC guideline and related press releases is that the body of evidence addressing the effectiveness or efficacy of opioid therapy for outcomes of pain, function, or quality of life was insufficient to contribute any studies for their analyses.
In reaching this conclusion, the minimal duration for inclusion of a long-term study was set by the authors as “>1 year,” the same threshold employed by a 2014 evidence report that informed the 2016 CDC guideline.
The same consultant was the lead methodologist for both the 2014 evidence report and the 2016 CDC guideline.
However, earlier systematic reviews of the effectiveness or efficacy of opioids for chronic noncancer pain, co-authored by the same consultant and based upon the best available evidence, had identified dozens of clinical trials and systematic reviews of this topic.
Although their conclusions were guarded due to the poor overall quality of the literature, both earlier reviews concluded that selected, carefully monitored patients might benefit from such therapy.
Because the 2016 CDC literature review may be viewed as an update of the earlier reviews, it was striking that the 2016 review reached far more negative conclusions about the risk-benefit ratio for long-term opioid therapy than did the 2009 and 2010 reviews.
The 2014 evidence report and the 2016 CDC guideline relied upon the absence of studies of a year or greater duration to advance recommendations reflecting a low perceived benefit-to-risk ratio of opioid use for chronic pain.
And that is how they justified opioid prohibition.
We wondered whether a more standard approach to study retrieval and inclusion would confirm or refute this perception. Issues related to study inclusion also have implications for switching from or preferring one therapy to another
In addition, we examined studies cited in in the Cochrane Library of Systematic Reviews addressing opioids, antidepressants, anticonvulsants, NSAIDs, and behavioral treatments.
Our objective was to assess whether differences exist between the duration of treatment trials for chronic pain using each of these modalities, if analyzed without applying the one-year minimum threshold for inclusion newly introduced in the 2014 AHRQ and 2016 CDC reports.
Filed under: General Problems
The CDCs lies and repressing of vital Lyme research, pathetic and inaccurate testing methods that result in clinical diagnoses and disability have killed and tortured many. Whose responsible for putting the CDC in charge of healthcare anyway ?
Welll ,,,we all knew it,,,,,,now heres the proof again,,,of what we chronic pain people were saying alllll along,,,,they should be charge w/murder,,the corrupt bastards at the cdc,,,seriously,,again,,,,if I had the money,,,Id be sueing Klondike bar,,dea,,,doj,,freidmen,,,all of them,,,,,they have killed people,,,,they have forced physical pain onto humanbeings that could be treated w/,MEDICINES,,.Klondyn MADE HIS OWN LITTLE PENNHURST for all those legitimate chronic pain humanbeings forced off their medicines,,and he is making millions off of the forced endurement of physical pain onto humanbeings,,Keep it up,,,keep exposing the truth we all knew was there,,jmo,,mary