The case of vertebroplasty trials: promoting a culture of evidence-based procedural medicine.

Overview

Two independent, randomized controlled trials of vertebroplasty for the relief of pain associated with vertebral fractures demonstrated that this procedure was no better than a sham intervention. Publication of the trial results prompted strong, critical commentaries by practitioners and professional societies. In this article we offer a psychological explanation of this dismissive response to rigorous scientific evidence, which appeals to the “placebo reactions” of physicians when dramatic improvement is noted in patients’ symptoms following administration of invasive procedures. We argue that the story of the response to the vertebroplasty trials underscores the need to develop a culture of evidence-based procedural medicine.