This article has as its starting point the American Society of Regional Anesthesia and Pain Medicine (ASRAPM) 2004 Bonica Lecture, "Pain Treatments: Elegant Theories, Inelegant Universe." That talk summarized over a decade of work I had been privileged to undertake with U.S. federal agencies producing clinical practice guidelines and evidence reports,1-4 the American Society of Anesthesiologists on guidelines,5,6 the Cochrane Collaboration7 on systematic reviews and meta-analyses, and other initiatives to help pain medicine benefit from evidence-based practice. This interest is ongoing.8 It was a great honor to deliver that lecture, particularly since my career as an anesthesiologist ...

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