Everybody Hurts: Pain Estimates Should Be Peer-Reviewed
An article used as the foundation for the claim that a quarter to half of the U.S. population suffers from chronic pain appears to have a lot to recommend.
It is based on data from 13 different studies. And, unlike the Scotland study that has been the focus of this series so far, the data come from nine different countries and one global analysis.
What Defines Chronic Pain? was written by Christa Harstall and Maria Ospina from the Alberta Heritage Foundation for Medical Research in Canada. They wrote:
CP prevalence estimates reported in the 13 studies range from 10.1% to 55.2%. The data reported in these studies indicate a higher prevalence of CP among females (usually from musculoskeletal origin) and significant use of health care resources by CP sufferers. Given that costs associated with severe CP must be considerable for health systems, individuals, and society, management of CP must be assigned high priority. Estimates of the size and characteristics of the population affected by CP provide a basis to design and deliver therapeutic efforts for those most likely to need and benefit from them. More stringent, systematic, and uniform methodological approaches to determine the prevalence of CP are needed.
Was this published in the New England Journal of Medicine? In Pain Medicine? In Epidemiology or any other peer-reviewed journal?
And that’s the first problem. The newsletter does not appear to have a peer review process. The newsletter’s fine print says, “Timely topics in pain research and treatment have been selected for publication but the information provided and opinions expressed have not involved any verification of the findings, conclusions, and opinions by IASP. Thus, opinions expressed in Pain: Clinical Updates do not necessarily reflect those of IASP or of the Officers or Councillors.”
I asked the newsletter and Harstall about the peer review process but have not yet heard back.
I’ll write about how hard Harstall and Ospina must have worked on this piece in a future post. But let’s step back for a minute to where this journey began. The claim about 75 million to 150 million Americans being in chronic pain was based not on a peer-reviewed journal article but instead on an op-ed in a newsletter from the American Pain Society. That op-ed then cited two other pieces, one of which was a peer-reviewed article from Scotland. The other is what essentially amounts to an op-ed, albeit one that required a considerable amount of work.
Should questions as important as how many people suffer from pain and whether they are being adequately treated be answered using opinion pieces in advocacy organization newsletters, no matter how well meaning the organizations are?
I’ll discuss that in my next post in the series.
Next: Old pain data don’t improve with age
Photo credit: Sarah G. via Flickr