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Thursday 03 March, 2016 06:06

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

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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?

We are now awash in a flood of health information, and barely a day goes by without a report of a spectacular new cure for a formerly incurable illness. However, many people find themselves increasingly frustrated in the face of the media barrage of confusing and contradictory health advice. One day, drinking alcohol is bad for your health; the next day it is reported to help prevent heart disease. One day, margarine is healthier than butter; the next day its not. One day fish prevents heart disease, then it doesnt! You may be exasperated enough to ask: Why cant researchers get their facts right the first time? And how are you supposed to make sense of what you read, if the experts themselves cant make up their minds?

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.

The outcome of the foregoing drawbacks is that patients are often confused and are not sure how the latest advances apply to them. They often flood their doctors clinics with false alarms. As a result, the media loses credibility, so that they often end up performing a disservice to patients and their doctors. Because the public is eager, for any scrap of medical news, the media often reports individual studies out of context, as if each study could stand alone. However, single studies rarely yield a simple yes or no answer to a medical question. One ought to realize that scientific discovery is a process that often takes years to unfold. In a sense, medical researchers are weaving a large tapestry that will eventually tell a complex story when one stands back to look at the whole picture.
An individual medical study can only contribute a small strand to the overall fabric. While the findings of individual studies may even seem to contradict one another, evidence accumulates gradually from scores of such studies. A coherent picture emerges slowly over time, and only then can we make definitive recommendations. One way of solving the problem arising due to misleading, inaccurate or piecemeal reporting on the medical front would be for newspapers or magazines to appoint medical doctors as consultants on their editorial panel, who can be used as a sounding board to assess the reliability and validity of a medical story. Also, as the media realizes the importance of health stories, hopefully, we will soon have full-time reporters who specialize in covering health stories exclusively. Till then, what can you do to separate the wheat from the chaff ?

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!

Second, look beyond the statistics. When reports hurl at you statistics like a 30 per cent increase or phrases such as a 50 per cent higher risk , take a closer look at the exact numbers. Many of us get turned off by numbers, but this attitude can prove dangerous: you need to ask yourself what the numbers really mean and how they apply to you? Benjamin Disraeli once remarked that there are three kinds of lies: lies, damned lies and statistics. Remember that statistical methods are simply tools,
and they can produce blatantly wrong conclusions unless sensibly used. One common way in which statistics can be misleading pertains to reporting of relative and absolute risk. A headline that screams X Doubles the Risk of Y is way off target if your chance of contracting Y is one in a million to begin with. Doubling the risk of Y only makes it two in a million! The relative risk (doubled) is nothing to worry about if the absolute risk (an increase from one to two in a million) is tiny.

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 epidemiological research; scientists closely study a large group of people and then collate their findings. Next, they extrapolate these findings to the general population . Because such a study is observational, it is a fairly useful method to uncover possible risk factors but it can never actually prove a cause-and-effect relation, because the interactions between humans and the environment are extremely complex.

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.

Often, the process of reading the original research study in a medical journal can be an intimidating task. However, editorials in the journal help place things in proper perspective. Also, review articles can help provide a broad overview of the research and its importance. Consumer health magazines also help demystify some of the research by providing understandable commentary.

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?

Initially, ask some basic questions: How likely am I to get this disease in the first place? Were the symptoms of the participants in the study at all similar to mine? Because perspective on depth is so often missing from news reports, some people focus on the latest details at the expense of the big picture. You should ideally follow the dictum: Be quick to question, but slow to change. Moreover, if the new information is in conflict with conventional wisdom, you should regard it warily. Trying to heed all the advice all the time can prove overwhelming and disconcerting. You should evaluate your individual risk profile, based on your lifestyle and family history, and then make appropriate changes that will give you the highest returns for your effort.

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 !

Read 64667 times Last modified on Wednesday 10 August, 2022 10:36

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