{"id":3389,"date":"2022-11-11T09:00:27","date_gmt":"2022-11-10T22:00:27","guid":{"rendered":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/academic-concerns-around-cannabis-and-pain-management-sciencematters\/"},"modified":"2025-11-10T12:45:31","modified_gmt":"2025-11-10T01:45:31","slug":"academic-concerns-around-cannabis-and-pain-management-sciencematters","status":"publish","type":"post","link":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/academic-concerns-around-cannabis-and-pain-management-sciencematters\/","title":{"rendered":"Academic concerns around Cannabis and Pain Management \u2013 #ScienceMatters"},"content":{"rendered":"<p><span style=\"font-size: 12pt;\"><strong><em>Investigating the veracity of a sample of divergent published trial data in spinal pain<\/em><\/strong><\/span><\/p>\n<p>PAIN:&nbsp;April 25, 2022 &#8211; Volume &#8211; Issue &#8211; 10.1097\/j.pain.0000000000002659<\/p>\n<p><strong>Abstract In Brief:&nbsp;<\/strong>Evidence-based medicine is replete with studies assessing quality and bias, but few evaluating research integrity or&nbsp;trustworthiness. A recent Cochrane review of psychological interventions for chronic pain identified trials with a shared lead author with highly divergent results. We sought to systematically identify all similar trials from this author to explore their risk of bias, governance procedures, and&nbsp;trustworthiness. We searched OVID MEDLINE, EMBASE, CENTRAL, and PEDro from 2010 to December 22, 2021 for trials. We contacted the authors requesting details of trial registration, ethical approval, protocol, and access to the trial data for verification. We used the Cochrane risk-of-bias tool and the Cochrane Pregnancy and Childbirth group&#8217;s&nbsp;Trustworthiness&nbsp;Screening Tool to guide systematic exploration of&nbsp;trustworthiness.<\/p>\n<p>Ten trials were included: 9 compared cognitive behavioural therapy and physical exercise to usual care, exercise alone, or physiotherapy and 1 compared 2 brief cognitive behavioural therapy programmes. Eight trials reported results divergent from the evidence base. Assessment of risk of bias and participant characteristics identified no substantial concerns. Responses from the lead author did not satisfactorily explain this divergence.&nbsp;Trustworthiness&nbsp;screening identified concerns about research governance, data plausibility at baseline, the results, and apparent data duplication. We discuss the findings within the context of methods for establishing the&nbsp;trustworthiness&nbsp;of research findings generally. Important concerns regarding the&nbsp;trustworthiness&nbsp;of these trials reduce our confidence in them. They should probably not be used to inform the results and conclusions of systematic reviews, in clinical training, policy documents, or any relevant instruction regarding adult chronic pain management.<\/p>\n<p><a href=\"https:\/\/journals.lww.com\/pain\/Abstract\/9900\/Investigating_the_veracity_of_a_sample_of.70.aspx\"><\/a>For more go to&nbsp;<a href=\"https:\/\/journals.lww.com\/pain\/Abstract\/9900\/Investigating_the_veracity_of_a_sample_of.70.aspx\">https:\/\/journals.lww.com\/pain\/Abstract\/9900\/Investigating_the_veracity_of_a_sample_of.70.aspx<\/a><\/p>\n<p style=\"padding-left: 60px;\"><em>On that basis we designed a protocol to systematically identify trials in this field from this author and explore aspects of the trustworthiness of the trials. We use a tool developed by the Cochrane Pregnancy and Childbirth group for this.&nbsp; To summarise our findings, we found 10 trials and identified a number of concerns across those trials that included: a lack of trial pre-registration, baseline values that did not seem consistent with randomisation, cases of erroneous (impossible) p values in baseline tables, extremely large effect sizes at both short and long-term follow up, (which is something that is really not common in the field of chronic pain and certainly not seen in other trials of CBT), and notably low or zero attrition in some studies. In addition we identified identical, and highly similar data across 3 trials reported as independent studies. On that basis we recommended that these trials should probably not be used to inform the results and conclusions of systematic reviews, in clinical training, policy documents, or any relevant instruction regarding adult chronic pain management.&nbsp;<\/em>Neil O\u2019Connell<\/p>\n<p><em>For complete commentary go to <a href=\"https:\/\/retractionwatch.com\/2022\/11\/09\/pain-researchers-lose-three-papers-after-cochrane-group-questioned-data\/\">Pain researchers lose three papers after Cochrane group questioned data \u2013 Retraction Watch<\/a><\/em><\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\" size-full wp-image-2660\" src=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-content\/uploads\/2020\/10\/DrPoppysWonderElixer.png\" alt=\"DrPoppysWonderElixer\" width=\"717\" height=\"473\" srcset=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-content\/uploads\/2020\/10\/DrPoppysWonderElixer.png 775w, https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-content\/uploads\/2020\/10\/DrPoppysWonderElixer-300x198.png 300w, https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-content\/uploads\/2020\/10\/DrPoppysWonderElixer-768x506.png 768w\" sizes=\"(max-width: 717px) 100vw, 717px\" \/><\/p>\n<p><span style=\"font-size: 12pt;\"><strong><em>Also see <\/em><\/strong><\/span><\/p>\n<ul>\n<li><span style=\"font-size: 12pt;\"><a href=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/medicinal-cannabis-blacklisted-by-australian-pain-specialists\/\">Medicinal cannabis blacklisted by Australian pain specialists<\/a><\/span><\/li>\n<li><span style=\"font-size: 12pt;\"><a href=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/nice-will-not-recommend-medical-cannabis-for-epilepsy-and-chronic-pain\/\">NICE will not recommend medical cannabis for epilepsy and chronic pain<\/a><\/span><\/li>\n<li><span style=\"font-size: 12pt;\"><a href=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/cannabis-and-cannabinoids-for-the-treatment-of-people-with-chronic-noncancer-pain-conditions-a-systematic-review-and-meta-analysis-of-controlled-and-observational-studies\/\">Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies<\/a><\/span><\/li>\n<li><span style=\"font-size: 12pt;\"><a href=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/cannabis-and-pain-helpful-what-is-the-evidence\/\">Cannabis and Pain \u2013 Helpful \u2013 What is the Evidence?<\/a><\/span><\/li>\n<li><span style=\"font-size: 12pt;\"><a href=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/false-hope-driving-claims-medicinal-cannabis-is-magic-pill\/\">False hope driving claims medicinal cannabis is magic pill<\/a><\/span><\/li>\n<li><span style=\"font-size: 12pt;\"><a href=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/doctors-accuse-britain-s-first-medical-cannabis-clinic-of-making-unfounded-claims-over-pain-relief\/\">Doctors accuse Britain&#8217;s first medical cannabis clinic of making unfounded claims over pain relief<\/a><\/span><\/li>\n<li><span style=\"font-size: 12pt;\">&nbsp;<a href=\"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/2018-papers\/\">Cannabis &amp; Pain &#8211; 2018 Papers<\/a><\/span><\/li>\n<\/ul>\n<p style=\"text-align: right;\">Dalgarno Research Team<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Investigating the veracity of a sample of divergent published trial data in spinal pain PAIN:&nbsp;April 25, 2022 &#8211; Volume &#8211; Issue &#8211; 10.1097\/j.pain.0000000000002659 Abstract In Brief:&nbsp;Evidence-based medicine is replete with studies assessing quality and bias, but few evaluating research integrity or&nbsp;trustworthiness. A recent Cochrane review of psychological interventions for chronic pain identified trials with a [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":2660,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":"","_wp_rev_ctl_limit":""},"categories":[46],"tags":[],"class_list":["post-3389","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-next-phase-platform"],"_links":{"self":[{"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/posts\/3389","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/comments?post=3389"}],"version-history":[{"count":0,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/posts\/3389\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/media\/2660"}],"wp:attachment":[{"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/media?parent=3389"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/categories?post=3389"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/tags?post=3389"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}