| By Michelle Gailiun
A pocketful of simple questions may be the best protection consumers
can have to cope with the flood of health and medical news that makes
headlines every day. Just how much is there? It’s hard to know,
but at least one estimate says the presses are spewing out at least
1,000 studies each day. But whatever the number, it’s leaving
a lot of consumers feeling like they are drowning in data.
“It is simply impossible to keep up with it all,” says Donn
Young, PhD, a biostatistician and senior research scientist in The
Ohio State University Comprehensive Cancer Center. “It’s
not just the sheer number of studies and stories, which is overwhelming
in and of itself, but it’s also the appearance of conflicting
results among studies examining the same phenomena. Does fiber prevent
colon cancer or not? Does a diet rich in fresh fruit and vegetables
really affect a woman’s risk of breast cancer or not? Trying
to make sense of it all is sort of like mental whiplash.”
So, what’s a person to do? For starters, Dr. Young suggests
asking a few questions. The answers will help you tell the good ones
from the bad ones.
How big is the study?
Size matters. Generally, the bigger, the better. A study examining
the side effects of a treatment that has 1,000 people in it is going
to be more meaningful than one evaluating the same thing in just
10 people.
Where was the study originally published?
Good science is usually published in a journal, rather than publicized
solely in a press release, presentation or self-published report.
Journals have panels of scientists that review and criticize studies
before they are published. If studies make it through the review
process, publication in well-known journals like the New England
Journal of Medicine, Science or Cancer give them even more credibility.
Who paid for the study?
Generally, there is less chance that a study funded by the National
Institutes of Health will be influenced by any conflict of interest
than one funded by a private company. For example, a recent study
showed that it is just as important to lower your C-reactive protein
level as it is to lower your cholesterol level to reduce the chance
of a heart attack. But Dr. Young points out that the study was conducted
by a scientist who developed a method to determine the level of C-reactive
protein in blood. If it’s important to lower C-reactive protein,
he could collect royalties on every sample tested.
What is the study
design?
There are sorts of designs, but the gold standards are case-control
studies in epidemiology and randomized trials in evaluating treatments.
In a case-control study, information about cases or people with disease
is compared with the same information on controls (people without
the disease). In clinical trials evaluating treatments, participants
should be randomly assigned to different groups, given a treatment,
and the results compared. The study gets bonus points if neither
the clinicians nor the patients know who is getting what, a design
referred to as “double-blind.” If a study is double-blinded,
it helps eliminate possible bias on the part of all participants.
How
should I understand findings involving risk?
There are two types of risk: relative risk and absolute risk.
They are both important, but different, and sometimes, it’s hard
to tell which one the author or reporter is talking about. For example,
a recent study showed that eating a lot of red meat increased one’s
risk of rectal cancer by 43 percent, compared to those who ate little
red meat. That is relative risk—comparing one group with another.
However, of the 148,610 adults in the same study, 470 developed rectal
cancer, so their absolute risk is 470 in 148,610, or 0.3 percent—or
about one in 300. Writers generally refer to findings in terms of
relative risk because it has a bigger “feel” to it. But
often, it’s the absolute risk that puts findings in better
perspective. |