Andrew J Engel1, Nikolai Bogduk2. 1. *Affordable Pain Management, Chicago, Illinois, USA engel.andrew@gmail.com. 2. The University of Newcastle, Newcastle, New South Wales, Australia.
Abstract
BACKGROUND: Diagnostic blocks are used in different ways for the diagnosis of spinal pain, but their validity has not been fully evaluated. METHODS: Four clinical protocols were analyzed mathematically to determine the probability of correct responses arising by chance. The complement of this probability was adopted as a measure of the credibility of correct responses. RESULTS: The credibility of responses varied from 50% to 95%, and was determined less by the agents used but more by what information was given to patients and if the agents were fully randomized for each block. CONCLUSIONS: Randomized, comparative local anesthetic blocks offer a credibility of 75%, but randomized, placebo-controlled blocks provide a credibility of 95%, and are thereby suitable as a criterion standard for diagnostic blocks.
RCT Entities:
BACKGROUND: Diagnostic blocks are used in different ways for the diagnosis of spinal pain, but their validity has not been fully evaluated. METHODS: Four clinical protocols were analyzed mathematically to determine the probability of correct responses arising by chance. The complement of this probability was adopted as a measure of the credibility of correct responses. RESULTS: The credibility of responses varied from 50% to 95%, and was determined less by the agents used but more by what information was given to patients and if the agents were fully randomized for each block. CONCLUSIONS: Randomized, comparative local anesthetic blocks offer a credibility of 75%, but randomized, placebo-controlled blocks provide a credibility of 95%, and are thereby suitable as a criterion standard for diagnostic blocks.