Wednesday, May 25, 2016

Comparison of Different Treatments for Hip Osteoarthritis

Studies on natural forms of healing are becoming more and more prevalent, though they are still pretty minimal compared to treatments that have been around for decades.  In the osteoarthritis world, treating hip arthritis has proven to be more difficult than treating knee arthritis.  Additionally, there are fewer studies on the treatment of hip arthritis as compared to the studies on treatment of knee osteoarthritis.


A recent study came out comparing natural platelet rich plasma (PRP) with long time used hyaluronic acid (HA) and with a combination of PRP and HA.  The results of this study were actually very surprising!  After using the STAR™ Blocks  to enter all of the information for each of the arms of the study, I was able to compare the actual effect of each one of the treatments.  





As you can see above, from top to bottom, are the HA alone, HA plus PRP and PRP STAR™ Blocks. It is clear by these comparisons that the PRP alone group had the best improvement in pain.  You can also see that this was a highly rated study, as the study design and the quality of the study were great. Is it surprising, then, to see that all 3 arms of the study only ended up with a Treatment Grade of "E"?


Such a low treatment score occurred with all 3 arms due to the low improvement in pain after 1 year. Even though all 3 treatments are safe, they are each pretty minimally effective for treating the pain associated with hip osteoarthritis.  

Here at treatment scores, we will continue to put a hard value on each treatment out there for every specific disease process.  Until we have concrete numbers to compare different treatments to each other, it remains a difficult task to understand the actual benefits of each treatment.  

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DISCLAIMERS:
You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

COPYRIGHT:

Copyright © 2016 Treatment Scores, Inc.

Wednesday, May 18, 2016

Treatment Scores Tutorial 1: Gross Benefit and Net Benefit

When you do your taxes, you figure out your gross income and net income. Before you undergo a medical treatment, you need to figure out the “gross benefit” and the “net benefit” of that treatment.

Why is this such a big deal? It’s a big deal, because the medical system has never provided Treatment Scores before. The Treatment Score = the net benefit of the treatment. Treatment Scores have been a secret, a mystery, unable to be calculated, and almost systematically hidden from you until now.

The Treatment Score represents the “net treatment benefit for the patient,” which is a long phrase so we simply call it the Treatment Score. In reality, the Treatment Score represents the “net absolute treatment benefit for the patient as determined by the patient during shared decision-making with the physician.” You can see why we simply call it the Treatment Score!

When you get sick with a disease, you need to review the medical literature for a list of treatments for that disease. In general, the more treatments that exist for a disease, the less effective the treatments are. For example, there are 130 treatments for insomnia, because most of the treatments for insomnia don’t work very well. There are 57 treatments for an acute migraine headache, because most treatments for an acute migraine headache don’t work very well. There are only a few treatments for stage I testicular cancer, because those treatments DO WORK WELL.

When you get diagnosed with any disease, for each and every treatment for that disease, you need to figure out the “gross treatment benefit” for patients that have been treated in the past. Then, you need to figure out the “net treatment benefit” for those same patients, which is the Treatment Score.

It has always been extremely difficult to produce Treatment Scores. Today, programming makes it possible to create Treatment Scores. Search engine technology makes it possible to find the statistics and database technology makes it possible to organize the statistics. Finally, new statistical methods enable us to calculate Treatment Scores.

What does all this mean for you? It means for the first time in your life you should ask your physician, “What’s the Treatment Score for that?”
(See the disclaimers below.)

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DISCLAIMERS:
You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

COPYRIGHT:
Copyright © 2016 Treatment Scores, Inc.

Thursday, May 12, 2016

Treatment Scores Saved Me from Having to Get Four Cavities Drilled and Filled

I like my dentist and have been going to him for many years. Last year, He used the DIAGNOdent laser diagnostic device and said I needed to have four cavities filled. The DIAGNOdent laser showed a cavity in each of my four wisdom teeth.

This was troubling, since I brush and floss, and have almost never had a cavity as an adult, but now had four of them!

2015 DIAGNOdent Readings

My 2015 DIAGNOdent laser readings in the four affected teeth were:

  • 17
  • 17
  • 15
  • 15

I left the dentist dismayed and shocked. This technology, the DIAGNOdent, had discovered four cavities in my teeth. The last thing I wanted to do was have four teeth drilled and filled! That’s painful! Suffering in the dentist’s chair has never been easy.

I decided to create a list of treatments for a cavity, and then figure out the Treatment Score for each one of those treatments.

The first thing I learned was that the DIAGNOdent can find “microcavities” not “actual cavities.” A typical “cavity” diagnosed by vision or x-ray goes all the way through the enamel and into the dentin of the tooth.

The DIAGNOdent laser is able to diagnose cavities that are “pits in the enamel,” but do not go through the enamel. Thus, they are called “microcavities.” They are also called “superficial cavities,” “surface caries,” “superficial caries,” “initial caries,” and “incipient carious lesions,” depending on how much of a stickler you want to be.

All these different terms are important, because their existence means that you have to search PubMed and other databases using all these different terms. The main point is that a microcavity affects the outer layer of the tooth, the enamel, only. DIAGNOdent readings can go from 0 to 99. I called KaVo Dental, because they make the DIAGNOdent to ask what a reading of 99 meant. They said it would mean that the cavity definitely goes all the way through the enamel into the dentin, but that your dentist should find and fix your cavities before they ever get that far.


DIAGNOdent Readings

On the KaVo Dental website I found this explanation for the DIAGNOdent readings:

0-10 means you have “Healthy Tooth Structure”
11-20 means you have “Outer Half Enamel Caries”
21-30 means you have “Inner Half Enamel Caries”
30+ readings mean you have “Dentin Caries”

(Source: http://www.kavousa.com/US/Customer/Document-Library.aspx Accessed May 12th, 2016.)

From reading medical articles, I became satisfied that the DIAGNOdent laser was a more sensitive method to detect microcavities than visual examination or x-rays.

Great! Catch cavities early, drill and fill them, and all will be wonderful! Right? Not so fast. Science-based medicine means going to the medical literature and seeing what it says.

After some more reading, I found out there are potential significant side effects to drilling and filling. Several articles theorized that when you drill through the enamel into the dentin to fill a cavity you increase the risk for tooth demise, because now you have a hole going all the way through the enamel and into the dentin of the tooth. That potentially opens up the inside of the tooth for bacterial contamination. Allegedly, every filling in your teeth, even if they are very superficial, put you at risk for more tooth deterioration, because the edges of the filling can be future spots for decay. As many people learn, fillings in your teeth do not necessarily last forever.

What did I want to achieve? What was the important outcome for me? After even more reading, I decided that what was important to me was the long-term survival of my teeth. The survival of the tooth was the most objective and significant outcome measure that I could find.

So, I wanted studies that focused on the long-term survival of the teeth. I wanted to be sure that whatever I did, that over the years, it increased the survival of my teeth instead of decreased the survival of my teeth. Many studies in medicine don’t go on for a lifetime, because that would be too expensive. So, I decided to look for five-year studies.

I want to keep my teeth in my mouth forever if possible. I want them all to survive my entire life span, but I was willing to start with five years.


Treatment List

I came up with a partial list of treatments for microcavities:

1. sugar reduction
2. acid reduction
3. watchful waiting
4. drilling and filling
5. ozone
6. fluoride toothpaste
7. fluoride rinse
8. fluoride varnish
9. fluoride gel


Treatment Scores

What Treatment Scores did I come up with?


All I found was “no data” = ND.

What I wanted to find was great studies for all of these treatments at the five-year mark. Instead, I was lucky if I could find a six-month or 18-month study that was tangentially related. I spent at least 20 hours on this project. It actually became a nightmare. Over and over again, I realized that for what I really wanted to know, all I could find was “missing data” or “no data.”

This is why we need Treatment Scores. We need to quantify what we know and what we don’t know. In addition, we can reduce the time spent searching the medical literature from 20 hours to 2 minutes.

What we don’t know is staggering. For example, Cochrane Reviews are one of the most respected sources of review articles. Yet, a statistician wrote this:

“…I'll like Cochrane when it answers 10% of the questions I get." - Jon Brassey, BSc
(http://evidencelive.org/speaker/jon-brassey/ Accessed 8/24/2015)

Jon Brassey, BSc hits the nail on the head. The problem with the medical literature as it exists today is that it doesn’t answer most of our clinical questions. In reality, we only know a lot about the “tip of the treatment iceberg.” All the rest of the treatments are “under the water.” We know very little about their treatment effects.

All I wanted to know was what the medical literature said about treatments for microcavities after five years of follow-up. What I got was the big squadouche, zip, nada, nothing, “no hard data situation.”

All these problems are why we invented Treatment Scores. We need to quantify medical treatments to find out what we know and what we don’t know. We need to start doing research to fill in the blanks. It’s my belief, that every practicing physician should be involved in clinical research. Believe it or not (I write sarcastically) it’s actually important that physicians, dentists, nurses, pharmacists, and everybody else know what they know and what they don’t know.


What did I do?

So, what did I do? Since I had no five-year facts, only impressions, I ended up treating my microcavities with fluoride toothpaste. How did that turn out for me?


2016 DIAGNOdent Readings

When I went back in 2016, the DIAGNOdent readings were as follows:

17
17
15
15

The DIAGNOdent readings were exactly the same! The dentist remarked that now he leaves such microcavities alone unless the reading is over 40.

The conventional wisdom, possibly the standard of care, and the medical literature have been changing over time. Fortunately, my dentist acknowledges change.

I like the DIAGNOdent laser technology. I like the idea of finding cavities early and either following them, or treating them, depending on what seems to be the best thing to do using science-based medicine and shared decision-making with the dentist.

The DIAGNOdent is an early warning system that you need to take better care of your teeth.

Early diagnosis of microcavities, when you thought everything was perfectly fine, certainly motivates you to learn and actually do something, whether that something is “watchful waiting” or something else from your treatment list.


What am I going to do now?

This next year I’m going to watch my diet more carefully. I have Coca-Cola®, Mountain Dew®, orange juice, and sports drinks in my refrigerator. These drinks are all acidic and sugary. When I drink them, I’m going to dilute them with water and ice to try to reduce the pH level. I don’t want concentrated acid washing across my teeth anymore. I should consider quitting them altogether.

I also drink black coffee which is supposed to be acidic.

I actually bought some pH paper and tested several of the things in my refrigerator. Remember that a pH of 7 is neutral, and anything less than 7 is acidic.

Energy drink 1, pH = 2.0
Iced tea with lemon, pH = 4
Caffeine free diet cola, pH = 4
Orange juice, pH = 4.0
Energy drink 2, pH = 5.5
Iced Tea in a bottle, pH = 6
Milk, pH = 7
Coffee, pH = 7 (surprise?)
Water, pH = 7

My testing was very crude and may not be accurate at all. You should look up the pH of things you drink on the Internet as there are some very good studies out there on the pH of various drinks. My coffee tested at pH equals 7, which I am suspicious about. I do make my coffee very weak, and perhaps I accidentally bought a brand of coffee that has a very low acid level.


Treatments

To summarize my treatment regimen for the next year I’m going to try to:

  • reduce sugar intake
  • reduce acid intake
  • continue to use fluoride toothpaste

I do not consider my treatment plan for next year scientific. I’m going to go back and try to create Treatment Scores for shorter time periods and with different outcome measures. I will probably try to look at “cavity resolution,” meaning that the cavity disappears, and I will look for short term studies of six months or a year, because long-term studies don’t seem to exist. I will also try to find more information about the side effects. At first glance, hard data on the side effects seems to be lacking for the long-term. What are the side effects of fluoride intake? How many randomized controlled studies will I be able to find at one year of follow-up? Or at five years of follow-up? These are important clinical questions that need to be answered. If I don’t quantify fluoride as a treatment, how will I know how beneficial or dangerous it might be?

The future of medicine will be Treatment Scores. Once the data has been organized in “Treatment Score fashion," automatic algorithms can be used to keep trying to improve the Treatment Score, or update the Treatment Score. Eventually, we will all understand treatments much better.

Am I doing the right things? Will I save my teeth or lose my teeth? Have I missed anything? Until treatment quantification is perfected with Treatment Scores I will always have nagging doubts. At least for one year, science-based medicine and Treatment Scores have saved me from undergoing drilling and filling of four microcavities.

The sad fact is that what we really need to know about medical treatments we often don’t know. It’s time to use health information technology for something that benefits both patients and doctors. We need to use health IT for Treatment Scores.

What will my DIAGNOdent readings be next year? (See the disclaimers below.)

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DISCLAIMERS:
You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

COPYRIGHT:
Copyright © 2016 Treatment Scores, Inc.

Saturday, May 7, 2016

Malignant Melanoma, Treatment Scores, and Drinking Your Own Urine

There is a woman who drinks her own urine to treat her cancer. I saw her on the television show “Tosh.0.” She has also been on “Strange Addiction.” Her name is Carrie and she says she started drinking her own urine after being diagnosed with melanoma, a type of skin cancer.

Carrie says on video that she underwent surgery, had 16 lymph nodes removed, and three of the lymph nodes had cancer in them.

According to the information given, her cancer was melanoma stage 3, which is also known as “malignant melanoma,” because it has spread to her lymph nodes. Any cancer that has spread to a new location (metastasized) is more serious than one that has remained localized.

A tumor is malignant if it has the capacity to spread locally or to other parts of the body.

In one video I saw, Carrie seemed to point under her arm as the place where the lymph nodes were removed. So one might assume that the original melanoma, if the diagnosis is correct, was somewhere near that area of her body. I have no access to any medical records, I only know what is reported on the Internet and on these TV shows.

Science-based medicine means going to the medical literature and seeing what it says. I want to know the Treatment Score for treating stage 3 malignant melanoma by drinking your own urine. The Treatment Score represents the net treatment benefit for the patient that can be seen in the existing medical literature.

Is drinking your own urine crazy? Is drinking your own urine supported by the Bible? What are the opinions of some alleged experts? These questions would all make for interesting essays, but science-based medicine is about the existing facts.

I produced a list of 8 potential treatments for stage 3 malignant melanoma. I started with surgery, surgery plus lymph node dissection, and surgery plus adjuvant therapy. Then, as the 4th potential treatment added “drinking your own urine.” I also added some more recently developed treatment possibilities such as: melanoma vaccine, Yervoy, Keytruda, and Opdivo.

My immediate goal is to come up with the Treatment Score for “drinking your own urine.” I started the process like any physician does when they do Journal Club. I searched PubMed, the Internet, and I searched the Trip Database, which is one of my favorite search engines.

Drinking your own urine, by the way, is also called: urgophagia.

The Treatment Score I came up with for drinking your own urine is zero. Or perhaps more accurately “no data.” There are no studies in human beings that I could find. I would summarize the situation like this:

Diagnosis: Melanoma stage 3
Treatment: drinking your own urine
Follow-up time: any
Treatment Score: No Data

Drinking your own urine falls under alternative medicine. Sometimes alternative medical treatments have data to support them and sometimes they do not. Science-based medicine does not reflexively condemn anything, the scientific method is to do studies (if ethical and feasible) and see what they say. In this case there do not seem to be any clinical studies that support drinking your own urine for malignant melanoma stage 3.

There is the possibility that “drinking your own urine” could have a negative Treatment Score, because it could be harmful. There are potential side effects. Drinking your own urine, which contains concentrated waste and minerals, could dehydrate you. In theory, it could cause kidney stones. Drinking your own urine, if it is infected, could expose you to the intake of bacteria, which could be dangerous. However, I could not find reports or studies that these side effects had actually happened when urine was used for the treatment of cancer.

For the time being, drinking your own urine as a treatment for malignant melanoma stage 3 is neither supported or refuted by the existing medical literature, but everyone should review the medical literature on their own in case I missed anything. Those who think drinking one’s own urine has potential merit, need to do clinical studies, and perhaps even before that need to find any potential mechanism of action that would support doing such studies. It may work or it may not work. The data do not seem to tell us one way or another at this point in time.

Treatment Scores are the future of medicine. When you get a diagnosis you need a list of treatments for that diagnosis and the Treatment Score for each one of those treatments. Your treatment list should include all Western medical treatments, all Eastern medical treatments, all herbal medical treatments, and all other alternative medical treatments.

Once we have medical treatments organized into lists of treatments with Treatment Scores, we will finally be able to make sense of the millions of medical studies that already exist. Big data, medical informatics, and clinical analytics will finally come together to do something vitally important that patients need right now. (See the disclaimers below.)

Sources:
Strange Addiction. Nov 8, 2012. Carrie's strange addiction is drinking her own urine which she believes will maintain her health. Accessed April 29th, 20016.
https://youtu.be/It3uCssJj5Y

Nina Mandell. Woman drinks her own pee. New York Daily News, 03/16/2012. Accessed April 29th, 2016.
http://m.nydailynews.com/entertainment/tv-movies/woman-drinks-pee-tlc-strange-addictions-article-1.1040794

Tosh.0 TV Show. Celebrity Profile. PEE LADY. Season 8, Episode 8. 03/29/2016.
Daniel sits down with a woman who believes that drinking and bathing in her own urine is the key to good health. (8:55) Tosh.0.
http://tosh.cc.com/full-episodes/55p8x3/march-29--2016---pee-lady

DOES THE BIBLE PROMOTE DRINKING URINE?
MARCH 26, 2011. Accessed May 6, 2016.
http://paulandkaelin.com/2011/03/does-the-bible-promote-drinking-urine/

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DISCLAIMERS:
You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

COPYRIGHT:
Copyright © 2016 Treatment Scores, Inc.

Tuesday, May 3, 2016

This Procedure Works Great! Oh Wait, This Procedure Doesn’t Work at All!

I recently read a thought provoking book, Cure: A Journey into The Science of Mind Over Body, by Jo Marchant, and I would recommend adding it to your reading list. A chapter in the book is about vertebroplasties, which are procedures done for vertebral compression fractures. Fractures of this sort can be miserable. Vertebral fractures occur when the bones of the spine become compressed; they are usually caused by trauma. They are most likely to happen in elderly patients with osteoporosis. They are painful and can severely limit mobility.

I am an anesthesiologist and have done anesthesia for kyphoplasties, which are very similar procedures to vertebroplasties. A kyphoplasty is where a tube is placed into the vertebral body, a balloon is inserted and filled with cement. This elevates the fracture and stabilizes the bone with the goal being pain relief for the patient. In fact, I vividly remember doing anesthesia for two patients undergoing these procedures. Both patients had significant pain pre-operatively. They were both looking forward to the procedure and were expecting good results.

When I saw them the day after their kyphoplasties, one of the patients had a lot less pain and felt great. The other patient still had some pain, but said it was decreased, and felt pretty good about having the procedure.

This seems like a rather satisfying result. The book I had read got me thinking about what the Treatments Score would be for this procedure. It seems there is a pretty significant decrease in pain levels post procedure usually in the range of a 30-40% decrease in the first few days. There is also an increase in functionality, but there are also some potential significant side effects, and the studies aren’t perfect, so something has to be subtracted to get a Treatment Score. I gave this procedure an initial Treatment Score of 30 for decreasing pain. My Treatment Score Calculator™ looks like this:


This is all well and good except that when two randomized controlled studies were done comparing vertebroplasties vs. sham surgeries, they found that the sham surgeries worked just as well. (Studies have shown similar outcomes when comparing vertebroplasties to kyphoplasties.) If we do a Treatment Score on sham surgery for compression fractures, the score turns out to be almost identical to the score for vertebroplasty as you can see from the Treatment Score Calculator™ below. It should be pointed out that these treatment Scores are in the immediate few days after the procedure. Over a longer time period, such as one year, there is no difference between having the procedure or medical management.


Now being an anesthesiologist, I don’t get to decide who gets what procedure. That decision has already been made by the time the patient reaches me. My job is to get them through the procedure as safely as possible. Having a procedure that doesn’t work any better than a sham surgery raises a lot of questions. Should we even be doing these procedures? Most of the patients with these fractures have osteoporosis and are elderly with significant medical problems. From my point of view, they can have significant anesthetic risks. As mentioned, there are several side effects to these procedures. For instance, there may be a higher risk of compression fractures at other levels, there may be some “sintering of bone” leading to spinal stenosis. I have even heard of a case at another hospital where a patient woke up paralyzed and died a couple of months later. Should I have made my Treatment Score a 0 (zero) since any side effect is not tolerable for a procedure that works no better than a sham surgery?

Why would anyone do a procedure that works no better than a sham procedure? Look at it this way, we have a patient who is in severe pain, unable to function, and all they want is to get better. Most of these patients will get better after this procedure. Medical management like braces and pain killers do not work as well. Do we need to tell patients that the procedure is no better than placebo knowing this will probably decrease the chance of them having a positive result? Some doctors can do these procedures in 15 or 20 minutes and others an hour and a half. Do we need to abandon the procedure if it is taking too long knowing the patient will probably get better anyway?

There are a lot of issues here and a lot of questions. As most of you know all too well, this is very common in medicine. I am not going to be able to answer these questions here and that is not really what Treatment Scores are about. Treatment Scores allow us to know what is already known and it seems apparent that the sham procedure works just as well as the surgical procedure for the patients in the studies I looked at.

It appears to me what we really need is a treatment that works just as well as the sham surgery and has less side effects. Maybe it will involve injection of stem cells or growth factors near the vertebral body. Who knows? I’m just speculating. However, I don’t know if anyone is really looking at the problem in that way and I think that will be another advantage of Treatment Scores. They will give us the ability to find out what is already known, and will make it more clearly apparent what is not known and what we need to find out.

Treatment Scores will also help us to determine what we need to know better. The first studies of vertebroplasties were comparing the vertebroplasty group against patients getting medications and braces, but not surgery. Some of these were randomized and some were cohort studies. The Treatment Score would need to be lowered since the studies were not controlled against a sham surgical procedure. They were not truly controlled studies. With Treatment Scores this would be apparent and at least it would be possible to recognize up front some of the limitations of this treatment. We need to know what we know, know what we don’t know, and we need to know what we need to find out. Treatment Scores can do this. Join us, support us, and let’s keep the TREATMENT TRANSPARENCY movement going.

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DISCLAIMERS:
You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

COPYRIGHT:
Copyright © 2016 Treatment Scores, Inc.

Sunday, May 1, 2016

Make Me Feel Better or Fix Me?

I spent this past week at a regenerative medicine conference.  What is regenerative medicine, you ask?  Regenerative medicine is a relatively new branch of medicine dedicated to healing the body using it's own innate properties.  There are many different types of regenerative treatments, including prolotherapy, platelet rich plasma, and stem cells.  Regenerative medicine is an up and coming field of medicine, and it is growing rapidly.  As society becomes less and less comfortable with taking typical medications that are prescribed, more and more people are turning to natural forms of treatment and healing.  Many people want actual solutions to their problems, as opposed to treatments for their symptoms.  You may think that this is obvious:  who wouldn't want a solution to their medical problem?  Well, the truth is that many people don't want to wait for a healing effect to occur, and prefer to just "feel better quickly" with the intent of possibly addressing the actual problem "once they feel better."  As you can probably guess, once a patient feels better, they tend to forget about the original problem at hand, and thus it rarely gets "fixed".

Just like after a woman has a baby and it takes time to lose the baby weight and for the body to return to it's pre-pregnancy state, in regenerative medicine, there are no quick fixes.  In using regenerative techniques, a patient must wait weeks, or even months, before they will see significant results. Regenerative medicine physicians aim to use the body's innate healing capabilities to help promote healing within individuals.  These treatments are being used in many fields of medicine, from orthopedics and rheumatology, to pulmonary and cardiac medicine alike.

The specific conference that I attended this weekend was about regenerative medicine in orthopedics, specifically.  Many physicians gave stimulating lectures on the many applications for stem cells and other regenerative techniques.  During the entire length of the conference, all I could think of was, "I wonder what that treatment would look like if I could actually quantify the net treatment benefit with Treatment Scores?"  I spent many hours of the lectures just writing down specific studies that I could go back and use for our STAR™ Blocks.  It is such an exciting time for regenerative medicine, as the studies that are coming out daily impact how we practice medicine every day.

Though I have not yet done so since the conference, please see some of my previous posts on Plasma Rich Platelets, stem cells, or prolotherapy in order to get a good idea about the efficacy of those treatments.  And check back to our blog in a few weeks to see newly emerging statistics and research on regenerative medicine procedures that are being performed on a regular basis. See the disclaimers below.

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You must consult your own licensed physician, or other licensed medical professional, for diagnosis, treatment, and for the interpretation of all medical statistics including Treatment Scores. Treatment Scores are for educational purposes only. Treatment Scores may be incomplete, inaccurate, harmful, or even cause death if used for treatment instead of consulting a licensed medical professional. No medical advice is being given. We DO NOT CLAIM to cure, treat, or prevent any illness or condition. Nor do our services provide medical advice or constitute a physician patient relationship. Contact a physician or other medical professional if you suspect that you are ill. Call emergency services (call 911 if available) or go to the nearest emergency room if an emergency is suspected. We are not responsible for any delays in care from using our website, our services, or for any other reason. We are not responsible for any consequential damages of any nature whatsoever. We make no warranties of any kind in connection with our writings or the use of TreatmentScoresBlog.com or TreatmentScores.com. Treatment Scores are about what happened to patients studied in the past; they do not predict the future.

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