A prominent Massachusetts anesthesiologist who greatly influenced how post-surgical pain in orthopedics is treated has admitted fabricating the results of 21 studies published between 1996 and 2008.

Scott Reuben, MD, a researcher at Tufts University's Baystate Medical Center in Springfield, Mass., falsified the clinical trials supporting studies published in anesthesiology, pain and orthopedic surgery journals, according to Anesthesiology News, which reported news of an investigation into the matter earlier this month.

Problems with Dr. Reuben's research were discovered last year during a routine audit by the medical center. A follow-up investigation found 21 faked studies and cast dozens more into question. "He was one of the most prolific investigators in the area of postoperative pain management," says Steven Shafer, MD, editor-in-chief of the journal Anesthesia & Analgesia. This "sets back our knowledge in the field tremendously." The journal published 10 articles based on the faked data, which it plans to retract.

In his articles, Dr. Reuben, who was a member of Pfizer's speakers' bureau and who received research grants from the drug firm, encouraged orthopedic surgeons to switch from generic first generation NSAIDs to proprietary COX-2 inhibitors to control post-surgical pain. Some of the drugs Dr. Reuben touted, such as Pfizer's Bextra and Merck's Vioxx, have been withdrawn from the U.S. market because of safety concerns.

Additionally, some patients may have experienced delayed recovery as a direct result of Dr. Reuben's fabrications, says Dr. Shafer. "We are talking about millions of patients worldwide, where postoperative pain management has been affected by the research findings of Dr. Reuben."

Dr. Reuben's lawyer told reporters that the anesthesiologist "deeply regrets that all of this happened."

Kent Steinriede

A recent investigation conducted in the wake of last year's hepatitis C outbreak has revealed that 25 of 49 Nevada ASCs reviewed failed to practice adequate infection control practices, according to state health authorities.

Investigators say close to one-third of the infractions involved the misuse of single-use devices, while sterilization and disinfection errors accounted for nearly half, according to a published report.

In the report, Marla McDade Williams, chief of Nevada's bureau of healthcare quality and compliance, is calling for inspections of the state's ASCs every 18 months instead of once every seven years, as mandated by current CMS regulations. It also notes that lawmakers have proposed annual inspections of the state's ASCs and office surgery suites.

State health officials shut down the Endoscopy Center of Southern Nevada in Las Vegas last year while investigating six hepatitis C cases allegedly contracted at the center. They discovered that the center had reused syringes, single-use vials of anesthesia and scope-cleaning solution. Since then, the state has recommended hepatitis C and HIV tests for over 50,000 patients as a result of nine cases of hepatitis C linked to two facilities.

Daniel Cook

The American College of Gastroenterology has updated its screening guidelines for colorectal cancer for the first time since 2000, recommending that patients undergo colonoscopies every 10 years, beginning at age 50.

The ACG guidelines differ from one developed by the Multi-Society Task Force on Colorectal Cancer in its designation of colonoscopy as the "preferred" strategy for screening, rather than one of a "menu of options." The organization explains that it based this decision on the effectiveness and cost-effectiveness of colonoscopy as well as patients' attitudes toward the procedure.

"A preferred strategy simplifies and shortens discussion with patients and could increase the likelihood that screening is offered to patients," says ACG president Eamonn M.M. Quigley, MD, FACG.

Despite this recommendation, the organization acknowledges that "not all eligible persons are willing to undergo colonoscopy for screening purposes" and suggests that these patients be offered alternative prevention tests, such as flexible sigmoidoscopy every 5 to 10 years or CT colonography every 5 years.

The new guidelines also advise: