Chapter 2: Health Headlines: Making Sense of Medical Stories in the News

its all story telling, you know. Thats what journalism is all about. - Tom Brokaw

All of us rely on the media (TV, radio, newspapers, magazines) to remain updated with the latest news. While making sense of the share prices in the financial section is straightforward, how does one interpret or understand the medical stories?

In order to maintain a balanced perspective, its important to remember that news, by its very definition, implies something new and unusual. This is why medical stories in the media often seem to be at loggerheads with what common sense tells us. After all, the hundredth study showing a relationship between high cholesterol and heart disease is hardly news, but the one study that shows that eating fat helps prevent heart disease is likely to become a headline — no matter how flawed it may be! The media is often guilty of oversimplifying or exaggerating results. Moreover, headline writers may focus on an angle that gives a distorted impression, which often means that facts are sacrificed at the altar of readability or circulation figures.

Many reasons can be attributed to the somewhat shoddy standard of reporting in the lay press with respect to medical matters. Editors crave for stuff which is new and doctors and hospitals are only to happy to tom-tom their latest gadgets and gizmos. Reporters are often not specialized enough to understand the medical technical background. Often, they do not do their homework properly, which results in misreporting, which is, unfortunately, a common occurrence in India. It is a sad fact that although most newspapers and magazines have a battery of expert financial reporters, few have full-time knowledgeable health medical reporters.

First of all, identify the source. Does the information come from a reputed publication (such as The Lancet) or a leading medical professional organisation (such as the American Heart Association)? Not that such identification can guarantee its reliability or trustworthiness either, but it helps to know that the information is coming from a respected and respectable source. At the other extreme of unreliability is information from a commercial source, or from an Internet newsgroup!

Third, scrutinize the results. Does this information reveal a direct cause-and-effect relation between two factors? Or is it merely an association? For example, someone could argue theres an association between matches and lung cancer because matches light the tobacco that causes lung cancer. But common sense would tell you that lighted matches dont cause lung cancer. Typically, years of consecutive studies are required to prove a cause-and-effect relation and the results of one study usually dont provide enough proof. If just one medical study has documented an unusual or peculiar finding, and if the results have never been replicated by any other study, then this situation suggests that the study is not reliable!

None of us wants to become a medical researcher, but it does help to know a little bit about the various types of medical research as well as their limits.

Basically, medical studies can belong to three categories:

• Laboratory experiments.
• Epidemiological research.
• Clinical trials.

Laboratory experiments can be carried out in test tubes or on animals such as mice, rabbits or guinea pigs. Results obtained from animal trials should never be applied directly to humans for several reasons. For starters, of course, people are not lab animals. Also, mice and other small creatures are not naturally subject to many of the common ailments that afflict humans; therefore, scientists have to alter them genetically or physiologically to create animal models for human diseases. The results of such studies are interesting and useful to scientists, and often pave the way for important advances, but they dont tell doctors which medicines to prescribe for people.

In contrast to epidemiological studies, which scrutinize the complexity of real-life cases, clinical trials provide a systematic way of testing the effects of one particular factor, such as a drug, under tightly controlled circumstances. Clinical trials, which are experiments performed on people, are thus the most reliable of the three categories, because they compare two carefully controlled groups of people. However, remember that these trials have their own limitations as well.

One important safeguard against imperfect or flawed scientific reporting is peer review; i.e., scientists scrutinize each others work in advance. Almost all well-respected scientific journals rely on peer review to select papers for publication. Any study that has not undergone peer review should be regarded with the utmost scepticism. For example, one should be wary of findings announced at a press conference that are not accompanied by publication in a journal or by a presentation at a scientific forum. At the same time, its also true that peer review is no guarantee by itself that a study is reliable. For example, expert reviewers have no way of knowing if an investigator has falsified the data in an article. And even if a study is well-designed and scientifically valid, it may have absolutely no relevance to most people.

The next crucial question is: how do you apply what you have learnt? Lets imagine for a moment that youve read a report about a new clinical trial and all the signs appear encouraging: its results confirm conclusions drawn from similar trials and the experts seem to agree that it has been well designed and has generated valid information. Now comes the difficult part: how can you use these new findings to improve your own health?

If a news report raises nagging doubts in your mind about your treatment , diet or lifestyle, make it a point to ask your doctor whether or not the report applies to you. However, most of the time you simply need to rely on your common sense. After all, its rather silly to worry about having missed ones daily quota of beta- carotene supplement while smoking the twentieth cigarette of the day !