Health reporting often follows an all-too-familiar pattern: New drugs or therapies are introduced with glowing accounts, followed a few years later by headlines warning about their dangers. Some people react to that uncertainty by dismissing all health and medical news, while others overreact by adopting — or abandoning — strategies too soon.
Part of the confusion stems from the normal unfolding of scientific knowledge, which is constantly evolving as new evidence adds to the existing body of research. But fault also lies in the way that medical research is published and pushed through the media, creating a broken system that has tremendous potential to harm consumers, says Gary Schwitzer, publisher of HealthNewsReview.org, a watchdog Web site that tracks the quality of health reports.
The following checklist will help you sift through the rubble of medical news you find online, on TV and in print.
●Check the background. Was the study published? If you don’t see the name of a peer-
reviewed medical journal and a publication date in an article, either pass or take the findings as preliminary. The journalist might be covering early research that is often presented at medical conferences. Such presentations aren’t peer-reviewed, and the findings might change if or when they are published.
●Who paid for it? Health-care research is rife with potential conflicts of interest. Pharmaceutical firms have provided almost 60 percent of all biomedical research funding in the United States, raising questions about the integrity of some drug studies. In January 2007, the online journal PLoS published an analysis of nutrition studies involving soft drinks, juice or milk; it found that more than half had industry funding. More important, the studies’ conclusions directly correlated with who funded them.
●What’s the context? A single study seldom constitutes strong evidence of anything and is even more rarely considered a clinical game changer. Instead, new conclusions should be presented in the context of what is already out there. Does the finding support existing evidence? Suggest a new benefit that warrants investigation? Raise safety concerns that earlier studies didn’t? Knowing where the new research fits in the body of existing data can help you decide what to make of it.
●Examine the methodology. Was it a controlled clinical trial or an observational study? The gold standard in medical research is the double-blind, randomized, controlled clinical trial, in which subjects are randomly assigned to a control (placebo) or experimental (active drug, substance or therapy) group. Neither the subjects nor the researchers know who is in which group until the study ends. In general, the more people who are in a clinical trial — ideally, hundreds or even thousands — the more weight you can put on the findings.
Observational studies, in contrast, compare large populations of people and look for connections between their habits and behaviors and various health outcomes. Those studies can suggest a link — say, between eating blueberries and strong brain function, or laughing a lot and lower blood pressure — but can’t prove a causal effect.
●Did it address confounders? That’s the umbrella term for all of the other possible factors that might explain a study result. For example, research may find that the risk of lung cancer is higher in factory workers. But before the reporter or study’s author pins the blame on the workplace, he or she must investigate the confounders, such as whether the workers were more likely than other people to smoke cigarettes.
●How long was the study? Studies done to gain approval for new drugs and devices can last for as little as a few weeks, and they rarely run more than a few months, which might not be long enough for potential risks to emerge.
●Grade the journalism. “More often than not, when we hear about new stuff, benefits are maximized and harms are minimized, and that is simply a bias and imbalance that we have to overcome,” Schwitzer says. “If you are hearing a message that sounds too good to be true, it is, because there are always harms.”
Don’t rely on a single news report. Check whether other stories give details or perspectives that provide a fuller picture. Also, look for responses from governmental agencies and reputable organizations, which can often help gauge how seriously to take the news.
●Determine what the news means. Do the findings apply to you? Many drugs that show promise in the test-tube stage or in animal research don’t turn out to be safe or effective in humans. And in human trials, some treatments are tested only in men or women, others only in young, healthy or sick people. So the less you resemble the subjects, the more reason to temper your enthusiasm.
●Do you have access to the care that the study participants did? Research on new medical treatments is often conducted by the best doctors in the best hospitals, skewing the results away from the average patient. Physicians at medical schools or large hospitals might have better equipment and training than your local doctor or medical center.
●What does your doctor think? Talk with your health-care provider about new treatments or other findings you’ve read about before rushing to judgment.