Treatment of pain in sickle-cell crisis

To the Editor: Griffin et al. (March 17 issue)¹ report decreased duration of severe pain in children and adolescents with sickle cell disease after treatment with high-dose methylprednisolone. There are serious deficiencies in the methods used in this clinical study that arouse both scientific and ethical concern. Simply stated, the authors confuse the duration of analgesic use with analgesia. They describe the main analgesic outcome measures as the number of morphine doses used, the need for continuous morphine infusions, and the duration of opioid therapy. Only the data on duration were statistically significant. Despite an abundant literature on pain measurement.