BMJ Guideline Response

IPSIS prepared and submitted a statement, supported by 33 other societies representing physicians who treat chronic pain, in response to a recent clinical practice guideline and systematic review/network meta-analysis published in The BMJ.

The response highlights the following:

• Heterogeneity: The systematic review/NMA and clinical guideline inappropriately aggregate diverse patient populations, diagnoses, spinal regions, and procedures.
• Omission and inaccuracy of extraction: Important studies were not included, and inaccurate data extraction from included studies casts doubt on reported results and conclusions.
• Technical fidelity: The publications fail to consider the importance of technical accuracy and procedural/technical factors that yield different results.
• Compassion and multi-modal care: These procedures are potential elective components of a multimodal treatment strategy and remain an essential treatment option for appropriate patients.
• Clinical guideline retraction request: Given the methodological issues and concerns regarding policy implications, The BMJ is encouraged to retract the guideline publication.

While interventional spine procedures are not a panacea, they can offer substantial relief, improve function, allow for return to work, and may delay or obviate the need for more invasive surgical interventions or long-term reliance on opioids for select patients suffering from chronic pain.

IPSIS remains dedicated to advocating for access to interventional pain procedures as essential treatment options for patients with chronic spine pain.

You can also help sustain this vital advocacy with your donations. The International Pain and Spine Intervention Society (IPSIS) is a tax exempt organization under US section 501(c)(3) of the Internal Revenue Code. As such, contributions are deductible to the extent allowed by law.