Opioids Are Not Better than Non-opioid Pain Medications for Chronic Back, Hip, or Knee Pain.

Bottom Line author Benjamin Oldfield and SPACE trial author Erin Krebs join Bill Fuller to talk about Dr. Krebs landmark study of opioids versus nonopioid management of chronic pain. Also there’s a cat. Also there’s a debate over pizza.

“Among patients with moderate to severe chronic back pain, or hip or knee osteoarthritis pain, treatment with opioids was not superior to treatment with non-opioid medications for improving pain-related function over 12 months.”

See the complete Bottom Line Summary at: https://www.ncbi.nlm.nih.gov/pubmed/31342325

Coronary Artery Calcium Testing Accurately Predicts Low Incidence of Cardiovascular Disease in Patients with Moderate to High Calculated ASCVD Risk

Coronary artery calcium (CAC) scoring is a non-invasive way to visualize calcified atherosclerotic plaque in the coronary arteries. But, so what? Physicians have struggled with what to do with this information and how we might incorporate CAC scores into clinical practice. The BioImage study may provide some insight with a prospective cohort study designed to see whether CAC scores predict incident ASCVD in patients at high risk according to the ACC/AHA pooled cohort equation.

Cardiologist Dr. Josh Levenson of University of Pittsburgh Medical Center takes us through what the evidence means to him and what this trial does to impact ASCVD prevention practices. Come listen to his interview with SGIM EBM Subcommittee Bottom Line author Clark Veet and podcast host Bill Fuller.

Here’s the SGIM EBM Subcommittee’s Bottom Line.

Questions or comments about the bottom line? E-mail Clark Veet at veetca@upmc.edu.

As always, feel free to reach out to Bill Fuller if you have comments on the podcast itself or would like to get involved!