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Is this Swedish groin pain study from 2012 to 2015 the best pain study to date?
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Ok, here were the levels in the Swedish questionnaire.
“The question put to the patient was: grade the worst pain you have felt in the operated groin during the past week. The seven possible scores were: 1, no pain; 2, pain present, but easily ignored; 3, pain present, cannot be ignored, but does not interfere with everyday activities; 4, pain present, cannot be ignored, and interferes with concentration on everyday activities; 5, pain present, interferes with most activities; 6, pain present, necessitating bed rest; and 7, pain present, prompt medical advice sought.”
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As for the (number of) meshes, it’s a good example of divide and conquer… the more the better for the manufacturers
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Exactly ie could they go back to their lifestyle? It would also be interesting in general to have a measure of the physical fitness of the patients and whether or not PR was prescribed and done before and after the surgery: the more tailored information is available the more informed the decision making process can be I guess?🤔
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The questionnaire that Dr. Kang used would be important to know also. I remember the posts about it but can’t remember if they used the same study, or if somebody assumed a correlation.
One thing that I see missing that would be important to know is whether or not the patients thought the pain was getting worse, better, or had leveled out. One year seems like a long time but it’s really not considering how long the mesh will be there. The choice of one year is arbitrary. Also, whether or not the patients had recovered their prior activity level or had reduced it to avoid the pain.
The study also has the same basic flaw that many do in not identifying the type of mesh used. All are lumped together as “mesh”. Maybe because the Registry does not record that data.
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Later today it might be helpful to bring over the open tissue and open mesh numbers from the Danish study.
Also, it will be interesting to bring over the Kang numbers for comparison.
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I think the 4 and 5 ratings should actually be 4 or more and 5 or more. This should mean that the 5 number is a subset of the 4.
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Open score of 4 – 15.1% (if I’m reading that right)
TEP score of 4 – 14.9%
Tapp score of 4 – 18.4%Open score of 5 – 10.1%
Tep score of 5 – 9.2%
Tapp score of 5 – 14.7 %Open low volume surgeons – 54.4%
Tep low volume surgeons – 23.7%
Tapp low volume surgeons – 29.7 %Low volume surgeon defined as less than 26 per year
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The ability to compare results is one of the two basic reasons why a graded pain standard is good.
I do think that choosing 4 and 5 as primary focus points is also helpful to people trying to understand what they are getting into. And, generally, those will probably be benchmarks that are somewhat telling for the overall pain numbers. For instance, the 5 numbers in the Swedish study fell off more or less proportionally in all three surgery types from the 4 numbers.
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They don’t know enough about their own results since they don’t follow up, and they certainly can’t compare to the results of other surgeons and procedures.
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