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On the validity and clinical utility of comparative local anesthetic blocks for the diagnosis of spine pain
Interventional Pain Medicine
ABSTRACT - This comprehensive review article revisits the validity and utility of comparative local anesthetic blocks, specifically in the diagnosis of spine pain. These blocks have provided an effective alternative to placebo controls. The discussion includes biostatistical principles involved in assessing the validity and clinical utility of diagnostic tests in relation to existing empirical studies. The review refutes recent claims questioning the clinical utility of these blocks, and highlights the need for studies that correctly test and compare the durations of action of the two anesthetic agents. It concludes that the validity of diagnostic tests is measured by likelihood ratios, and the clinical utility is measured by the diagnostic confidence provided by these likelihood ratios according to the prevalence of the condition being diagnosed.
