I was a subject on the A-TEAM trial. My tardy response is because I
was told that subjects would be informed of the study results. To date
this has not happened, I only found this paper when a friend mentioned it
to me.
In Table 5, which gives the one year results, SF-36, “quality of life
mental” shows no effect. This seems to have been overlooked. It is
desirable to reduce days of back pain, but until this is zero there is the
constant reminder of the underlying problem. Is it not this continual
worry of exacerbation that is wearing, reduces activity levels and leads
to the low mental state?
The authors say that they used primary outcome measures that have
been well validated. Were the subjects used in the validation
specifically asked what outcome they would value most following therapy?
I would think not. Certainly the subjects in the ATEAM trial were not
asked. It is surprising that the authors do not distinguish bewteen what
they want to measure and what patients might want them to measure. Why do
they think that patients would value an “improvement” on their scales?
The validation or otherwise of the wrong measure is irrelevant.
As a patient, for me, the take home message for this study is that
none of the therapies cures back pain, therefore, they are not worth
bothering with.
Rapid Response:
A trial subject's perspective
I was a subject on the A-TEAM trial. My tardy response is because I
was told that subjects would be informed of the study results. To date
this has not happened, I only found this paper when a friend mentioned it
to me.
In Table 5, which gives the one year results, SF-36, “quality of life
mental” shows no effect. This seems to have been overlooked. It is
desirable to reduce days of back pain, but until this is zero there is the
constant reminder of the underlying problem. Is it not this continual
worry of exacerbation that is wearing, reduces activity levels and leads
to the low mental state?
The authors say that they used primary outcome measures that have
been well validated. Were the subjects used in the validation
specifically asked what outcome they would value most following therapy?
I would think not. Certainly the subjects in the ATEAM trial were not
asked. It is surprising that the authors do not distinguish bewteen what
they want to measure and what patients might want them to measure. Why do
they think that patients would value an “improvement” on their scales?
The validation or otherwise of the wrong measure is irrelevant.
As a patient, for me, the take home message for this study is that
none of the therapies cures back pain, therefore, they are not worth
bothering with.
Competing interests:
None declared
Competing interests: No competing interests