Every now and then I like to reach into the Flashfree archives and repost a piece that either has lasting relevance or is a must-read for those of you who are new to the blog. This post originally ran in May of 2008 but continues to occupy the top ten list of importance in my mind. The topic? How do you discern information in a study and what do you need to look for. Plus, there’s an added bonus for all you Led Zeppelin fans.
Today’s Bubble – are you dazed and confused?
[youtube=http://youtube.com/watch?v=Xajqf-PhO8s&feature=related]
A gal pal mentioned to me this morning that she often feels so confused about study findings proving or disproving the value of certain medications or herbs that she often just throws up her hands and does nothing. Many of us are as dazed and confused as she is so that I thought that a few key points about clinical studies might help.
Mike Clarke from the School of Nursing and Midwifery at Trinity College in Dublin wrote a great article last year about the need to standardize results of studies for a specific disease ( in this case, rheumatoid arthritis). He defined the problem as follows:
“Every year, millions of journal articles are added to the tens of millions that already exist in the health literature, and tens of millions of web pages are added to the hundreds of millions currently available. Within these, there are many tens of thousands of research studies which might provide the evidence needed to make well-informed decisions about healthcare. The task of working through all this material is overwhelming enough without then finding the studies of relevance to the decision you wish to make…”
So what do you do? A few key points:
- Consider that every study has the potential for bias. Perhaps researchers are using 7 instruments to measure depression and only highlight findings from 3 of these in order to preserve the most positive or significant results. Clearly, the reader is being led towards certain outcomes and away from others.
- Study designs, types of patients studied, age of patients studied, gender, you name, can differ so it’s difficult, if not impossible to draw definitive conclusions when comparing results of one to another.
- Another issue of great interest to practitioner of Western medicine is whether or not a study is controlled. This means that two groups are compared that are identical in every way except one group is given an experimental treatment and the other, a placebo or standardized treatment. Note that often, real world conditions are often recreated rather than conducted in a real world setting and many studies are not controlled, meaning that the science behind the findings is questionable.
- Alternative and complementary medicines are still incompletely understood among many practitioners of Western medicine. What’s more, products are not regulated as carefully as medicinal agents and manufacturing practices vary. Consequently, studies of these agents or modalities are often inconclusive. And of course, often underfunded and under-appreciated.
No wonder we all feel so dazed and confused!
I’ve written several times about the importance of consulting a practitioner or medical expert before embarking on any regimen for perimenopausal symptoms. Even if you only see someone once, at least that dialogue may be useful for defining a regimen that may work best for you and what you’re going through. And if you live off the beaten track without access toa good practitioner, well then excellent resources like Medline or the American Botanical Council may be be of help in discerning what’s what.
The short answer is that there are no short answers. But with careful guidance and a bit of prudence, you may just be able see the light and smooth out the bumps on this rollercoaster ride we’re all on.
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- Can you trust clinical research | FlashFree : Not Your Mama's Menopause - [...] to learn more? Check out this post from December, 2010; there’s a few pointers on what to look for…
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Liz, great post! Yesterday I was with a friend at the hospital where she was having a lumpectomy. I was waiting for her in the waiting room, where the constant (and unfamiliar to me) din of daytime television was keeping me from being productive. At one point my shock transcended the usual surprise at the bad taste of programming — I was now looking at some game-like show called “The Docs”, or something like that these 4 good-looking young LA docs ( think they had real credentials), were giving 3-5 minute blurbs on the latest and the greatest (how coffee prevents cardiac arrhythmias, and the like). I have to admit, it made me livid. To present hypothesis-generating research as the final word in medicine is beyond irresponsible! This is why we have this see-saw of healthcare information that is confusing everyone.
Research is not sexy — it is painstaking discovery and endless confirmation of hypotheses. A single study can never provide all of the information, for all the reasons you have so well laid out. We need to stop this sensationalized coverage of every clinical result, regardless of how worthy or unworthy.
Blog on, Liz!
Thank you Marya. Wonderful points – as a society, we have become accustomed to the sound bite, content without context. However, the sound bite can actually hinder, not help our health. Cheers to you!
Great post! The way the media presents each study is somewhat irresponsible, with headlines causing alarm and drawing conclusions – at WVFC, our medical board tries to take a step back and look at each study but it is very important to consult your own medical practitioner before making changes to your routine.
Thank you for your comment! It’s often difficult to discern what’s what, but it is essential to at least know you should!
One good source of information is Cochrane Reviews.
Cochrane takes a bunch of studies, applies meta statistical analysis, & tries to really get at the data – so a not so rigorous study with 5 participants which found X has some effect would not carry as much weight as a really rigorous study with a large pool of participants which found X was only as useful as the placebo….. This type of meta analysis of a large number of studies is really the only thing I look at these days (& the few really large scale studies running globally)
On a funnier note – have you seen The Guardian’s satirical advice on writing an article about a scientific paper?
http://www.guardian.co.uk/science/the-lay-scientist/2010/sep/24/1
Once you read it you’ll recognize all the techniques employed in the media….. 🙂
Hi Hornblower. Thanks for stopping by. My issue with Cochrane (which I use quite often in my regular work), is the dearth of analyses of certain topics. They tend to fall a wee bit short in the alternative arena. Still, it is an invaluable resource. And thanks for the link to the Guardian piece – that will be tweeted for sure.
Best to you!