Problems with insurance-based research on chronic pain.
Evidence acquired through research is increasingly being used to manage medical problems, and, where applicable, to decide on which medically related conditions warrant compensation for disability. Consensus-based guidelines are supposedly prepared by learned individuals, making use of the best evidence and their experiences to provide group wisdom for practicing clinicians. Because bias is always a problem, research strives to minimize bias through scrupulous methodology, while consensus panels work carefully through the constitution of the group and disclosure of conflicts of interest by participants. Where research is not funded at arm's length by the external funding agency the potential for bias is enormous, especially when substantial funds are at stake, depending on the outcome of the study. In order that future research and consensus group recommendations may result in better care and a fairer compensation system, substantial efforts to minimize bias will be required.
Merskey
Harold
H
Department of Physical Medicine and Rehabilitation, University of Western Ontario, Parkwood Hospital, London, Ontario N5Y 2P9, Canada. harold.merskey@sympatico.ca
Teasell
Robert W
RW
D002170:Canada; D002908:Chronic Disease; D016265:Conflict of Interest; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D010146:Pain; D059408:Pain Management; D012109:Research Support as Topic; D013222:State Medicine; D014481:United States; D014942:Workers' Compensation