Wednesday, June 25, 2014

In a world of highly variable health care reporting--some good, some fair, and some poor--you might find it unlikely that some of the best work comes from Milwaukee, Wisconsin.  But John Fauber at the Journal Sentinel has the skill to put out consistently excellent work.

Here's the latest example, well worth reading, about the estimates that are bandied about by public officials and others concerning the number of people in America who suffer from chronic pain.  John notes:

[N]ine of the 19 experts on the panel that produced the number had financial connections to companies that manufacture narcotic painkillers within three years of their work on the report.

Some were officers or board members of groups that received opioid company funding, others were drug-company consultants or were paid for educational programs funded by companies that make pain drugs.

While that membership configuration, per se, doesn't invalidate the estimate, it appears that the report may have had methodological problems:

In February, two experts connected with the pain report said the 100 million figure was exaggerated and misleading and they raised concerns about how it was being used. Their comments came at a meeting of pain experts held at the National Institutes of Health.

One of the examples of misuse?  The Commissioner of the Food and Drug Admininstration:

When FDA Commissioner Hamburg brought up the figure at a three-day summit on America's opioid epidemic in April, she went even further than the report did. She said concerns about opioid abuse must be balanced against "the very real medical needs of the estimated 100 million Americans living with severe chronic pain or coping with pain at the end of life."

But the pain report does not apply the figure to "severe chronic pain." Rather, it says 100 million suffer from "common chronic pain."

And so on. You can read for yourself. What I enjoy about this story is how well researched it is, as well as its construction.  It is readable and interesting and lets the reader have enough information to draw thoughtful inferences.

I wish more reporters were given the training and time (and space) to produce reports like this.  In the meantime, I'm pleased that we can look to Milwaukee for more excellent work along these lines.

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