PubMed · 8232990
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R W Stout. 1993. Another viewpoint.. https://pubmed.ncbi.nlm.nih.gov/8232990/
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In randomized controlled trials (RCTs), study participants and research personnel are often blinded to minimize biases related to knowing treatment allocation. To determine if blinding was effective, participants may be asked which treatment they believe they received ("treatment guess"). This descriptive review characterized blinding assessment (BA) reporting in pharmacotherapy and neuromodulation neuropathic pain RCTs. Of 288 papers, 36 (12.5%) reported a BA. One paper reported the results of 2 studies, so in total 37 studies with a BA were assessed. Of these, 19 were crossover, 17 parallel, and 1 partial crossover in design. All 37 studies assessed participant blinding, and 10 also assessed investigator blinding. Approximately 27% included an "unsure" answer option for treatment guess, and 38% asked the reason for the guess. There were no clear patterns in BA reporting across time nor based on treatment type. Seventeen trials provided sufficient data to calculate Bang Blinding Index (BI) to determine blinding success. Participants remained blinded (BI = 0 ± 0.2) in 10/17 placebo and 10/17 treatment arms, 6 placebo and 5 treatment arms had a BI > 0.2 suggesting possible unblinding, whereas 1 placebo and 2 treatment arms had a BI < -0.2 suggesting misinformed guessing. Overall, we found that BAs are done in a minority of published neuropathic pain trials and with variable methodology. Given the importance of minimizing risk of bias because of treatment unblinding, future studies should consider including BAs, and further consensus building is necessary to determine if and how BAs should be conducted and interpreted in analgesic clinical trials.
The public is poorly served by the coverage of medical science in the general press. Scientists and physicians blame the press, claiming that journalists are careless in their reporting, subject to competitive pressures, and ignorant of the scientific process. Journalists accuse the medical community of limiting access to information and erecting barriers to the public dissemination of medical research. In many areas of health news reporting, the underlying problem is an interactive dynamic that involves scientists and journalists. Both parties share the responsibility for accurate communication to the public. This report suggests ways to improve health news reporting, focusing on four problem areas: sensationalism, biases and conflicts of interest, lack of follow-up, and stories that are not covered.