Where is the Evidence? A Critical Review of Bias in the Reporting of Clinical Data for Exparel: A Liposomal Bupivacaine Formulation

Abstract

Healthcare policies are formed through the dissemination of clinical information or evidence of effectiveness, so that this evidence can reach clinical practice. Manipulation or 'influence' over the data and the subsequent reporting of data can be introduced by anyone involved in a study. This may affect the perception of the evidence that becomes the basis for the determination of best practice in the care for our patients so it must be free of bias. This report illustrates an example of bias introduction into the clinical evidence portfolio of the recently introduced liposomal encapsulated bupivacaine Exparel™. This review then uses this new drug as an example of how bias is introduced into the clinical decision tree and its potential effect on the practice of medicine.