Why is research necessary?
What do you think of when you hear the term ‘scientific and medical research’?Many of us will probably think of men and women in white coats studying incomprehensible conditions with impressive pieces of machinery. Hopefully this text will give you a bit more information on how scientific research can really make a difference to you and how BackCare stimulates research in the area of back pain. You will see that medical research is not as baffling as you might have thought…
In the early days of medicine, doctors had to rely on their own experience and a lot of trial-and-error. You can imagine that in many cases the doctors were wrong and the outcome for the patient was not as positive as the patient might have liked. To improve the chances of a positive outcome, people started to look at diseases and treatment in a more structured manner. A famous example is Dr John Snow, who in the 19th century discovered that an outbreak of cholera was related to contaminated water coming from a pump in Soho in London. Although the number of such important discoveries is small, it does illustrate that looking at certain phenomena in a structured way can reveal much more useful information that trial-and-error.
Modern medical research shares much of the same principles as the ones used by Dr Snow in 1854. For back pain research this means that the research aims to look closely at what factors contribute to back pain and how these factors can be influenced. The better the understanding we have about back pain, the better we can tailor a treatment.
At the same time we know that such evidence-based medicine will not have the answers to all questions. The aim of evidence based medicine is to assist health care providers in giving the best possible treatment. Besides the scientific evidence, experience, clinical judgement and patient preferences are important elements of this process.
BackCare and research
Part of BackCare’s mission is to support research into the causes, prevention and management of back pain. We do this by:- Awarding grants to high quality research projects
- Sponsoring the BackCare
Award for best research paper at the annual Society for Back Pain
Research conference.
- Encouraging dialogues between researchers, clinicians and patients.
- Representing patients at various research projects.
For more information on the role of animal testing in medical research you can go to www.amrc.org.uk
So what can research do for you?
If you buy a car, you want to be sure it is reliable. If you are a car mechanie this will be fairly easy to do, but if you are not a you will have to use other methods to find out if the car is a good buy. You can use the internet to find information on the car in question, you take a test ride, you check the MOT and the logbook or perhaps you ask a friend with a similar car. All this information will hopefully give you all you need to assess the reliability and safety of the car you want to buy and whether the car is good value for money.You can apply the same principle when deciding on what treatment to follow for your back pain, although you will have to use different methods than an MOT or test ride. The question remains the same: is the treatment reliable, safe and good value for money? Hopefully research has addressed these questions and you can expect any qualified healthcare professional to know about this.
Different types of research
There are a number of different ways of assessing the effectiveness of treatments. Some methods are better than others and only if you use the best available methods you can be sure that the results are true.The best method of comparing one treatment with another treatment is by doing a so-called double-blind randomised controlled trial (RCT). This means that you recruit a large group of people that are fairly similar. At random you allocate half of this group to the one treatment and the other half to the other treatment. Ideally neither the people undergoing the treatment nor those giving the treatment or evaluating the treatment should know what treatment the group has been given. This is easier to do when comparing one pill with another pill but can be more complex when assessing other types of treatment such as physiotherapy.
When a RCT is well conducted, you can be sure that you are really comparing the effectiveness of the two treatments and no other factors could have played a role.
Other types of research are less able to control the possible impact of other factors. For example, if you don’t allocate the people at random but you let the participants in your study choose what treatment they wish to follow. In this case you will not only be testing the effectiveness of the treatments but also of the role of individual choice and you cannot separate the two.