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Volume 7 Journal of Pain & Relief
ISSN: 2167-0846 Pain Management 2018
October 11-12, 2018
Page 36
conferenceseries.com
October 11-12, 2018 | Zurich, Switzerland
7th International Conference and Exhibition on
Pain Research and Management
Nelson Hendler, J Pain Relief 2018, Volume 7
DOI: 10.4172/2167-0846-C1-019
Evaluating chronic pain patients using methods from Johns Hopkins Hospital physicians
C hronic pain patients are misdiagnosed 40%-80% of the time, according to research from Johns Hopkins Hospital physicians.
The most common of these misdiagnoses is sprains or strains, which are listed in medical textbooks as self-limited disorders,
which resolve in less than three weeks without treatment. Yet these diagnoses account for over 50% of diagnoses in patients with
pain for more than three months. On the other hand, certain diagnoses are overused, and misapplied without attention to published
diagnostic criteria. Therefore, complex regional pain syndrome (CRPS) formerly called reflex sympathetic dystrophy (RSD), and
fibromyalgia, are over diagnosed 71% to 97% of the time, to the detriment of the patients. The leading causes of these errors in
diagnoses are: failure to take a complete history, and using the wrong medical tests. As an example, MRIs fail to detect damaged
discs 78% of the time compared to a provocative discogram, and CT fail to detect bony lesions 56% of the time compared to 3D-CT.
Two expert system internet questionnaires are discussed. The pain validity test predicts the presence of abnormal medical testing
with 95% accuracy, which validates the complaint of pain, and detects drug seeking behavior. Another internet based expert system
the diagnostic paradigm, provides diagnoses with a 96% correlation with diagnoses of Johns Hopkins Hospital physicians. The
associated treatment algorithm recommends the appropriate tests to use for confirm the correct diagnosis. The value of these two
systems is documented by published outcome studies, which demonstrate patient improvement rates far higher than other methods.
These publications report cost savings $20,000 to $175,000 a case, with an 89% reduction in narcotic use, and a 45% reduction in
doctor visits. Between 50%-63% of patients need surgery to improve.
Recent Publications
1. Hendler N and Baker A (2008) An Internet questionnaire to predict the presence or absence of organic pathology in chronic
back, neck and limb pain patients. Pan Arab Journal of Neurosurgery 12(1):15-24.
2. Davis R, Hendler N and Baker A (2016) Predicting medical test results and intra-operative findings in chronic pain patients
using the on-line pain validity test. Journal of Anesthesia and Critical Care: Open Access 5(1):00174.
3. Hendler Nand SpurgeonD (2007) Comparison of clinical diagnoses versus computerized test diagnoses using theMaryland
clinical diagnostics diagnostic paradigm (expert system) for diagnosing chronic pain in the neck, back and limbs. Journal of
Anesthesia & Critical Care 6(5):00242.
4. Hendler N (2017) Facial pain from various sources-diagnoses, and differential diagnoses. Dental, Oral and Craniofacial
Research DOI: 10.15761/DOCR.1000220.
5. Hendler N (2017) An internet based questionnaire to identify drug seeking behavior in a patient in the ED and office.
Journal of Anesthesia & Critical Care, Open Access 8(3):00306.
Biography
Nelson Hendler has graduated cum laude from Princeton University. He has an MD and MS in Neurophysiology from University of Maryland School of Medicine. He did
his Residency in Psychiatry at Johns Hopkins Hospital and remained as the Faculty at the Medical School for 31 years. He has published 4 books, 33 medical text book
chapter, and 65 articles. He has lectured in over 60 hospitals and medical schools in the US and in 10 other countries. He has served as the President of the American
Academy of Pain Management and the Reflex Sympathetic Dystrophy Association of America and served on the board of the Lightning Strike and Electric Shock Survivors
International.
Nelson Hendler
Johns Hopkins University School of Medicine, USA