January 14, 2014

The dangers of better measurement

An NPR News story on back pain and its treatment

One reason invasive treatments for back pain have been rising in recent years, Deyo says, is the ready availability of MRI scans. These detailed, color-coded pictures that can show a cross-section of the spine are a technological tour de force. But they can be dangerously misleading.

This MRI shows a mildly herniated disc. That's the sort of thing that looks abnormal on a scan but may not be causing pain and isn't helped by surgery.

This MRI shows a mildly herniated disc. That’s the sort of thing that looks abnormal on a scan but may not be causing pain and isn’t helped by surgery.

“Seeing is believing,” Deyo says. “And gosh! We can actually see degenerated discs, we can see bulging discs. We can see all kinds of things that are alarming.”

That is, they look alarming. But they’re most likely not the cause of the pain.

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Thomas Lumley (@tslumley) is Professor of Biostatistics at the University of Auckland. His research interests include semiparametric models, survey sampling, statistical computing, foundations of statistics, and whatever methodological problems his medical collaborators come up with. He also blogs at Biased and Inefficient See all posts by Thomas Lumley »