To separate fact from misunderstanding, give medical studies a thorough checkup
09:42 AM PDT on Tuesday, August 24, 2004
We're buried in a blitz of medical information. It's become almost a daily ritual for newspapers, TV news shows and Web
sites to report new research findings or health guidelines. These studies -
often conducted by clinics and universities - typically appear in journals
before the mass media pounce on them. You might ask: What can be bad about sharing cutting-edge science or
medical innovation? The problem is that media reports may be incomplete, biased or overly
simplistic. Or worse, the study itself may be flawed, said Dr. Bruce L. Flamm,
an OB/GYN specialist at Kaiser Foundation Hospital in Riverside. "It's not the media's fault," said Flamm, who blew the whistle on
a dubious study published in 2001 by Columbia University doctors claiming that
prayer could help women undergoing in-vitro fertilization to conceive.
"Reporters are attracted to dramatic results, and in this case miraculous
results." Flamm, a clinical professor of OB/GYN at UC Irvine, recited the old adage:
"If it sounds too good to be true, it probably is." Partially as a result of Flamm's efforts, the Columbia report was pulled
off the Web site of the prestigious Journal of Reproductive Medicine this
month. The case reminds people to never blindly accept the latest medical findings
- or to try a fad diet or medical regimen because it was hailed on the evening
news program, Flamm said. Even solidly conducted, well-meaning research can be
contradicted by later research. "Still, it's possible for the average person to learn how to think
critically and ferret out fraudulent findings and things that don't make sense
from the get-go," Flamm said. Here are some guidelines: Read the original study. Your primary-care doctor or
specialist can interpret new findings. But patients who prefer to form their
own opinions should base them on more than media reports. For more in-depth
information, go online or to a medical library to obtain a copy of the journal
article. The article will have several parts: a title, a list of authors and
researchers, an abstract or brief summary, and the actual report. The study
will include an introduction with background information explaining goals and
providing some scientific perspective. Then comes the methodology, results and
a final discussion. Check on who published the study. Did it appear in a top
medical journal or a second-tier publication? Typically, major journals such
as JAMA or the New England Journal of Medicine will publish the most
significant research findings. Before publication, two or more scientists in
that field have evaluated the study for accuracy. But even the best journals can make mistakes, Flamm cautioned, so talk with
your physician before making a lifestyle change based on a study. One major warning: Watch out for medical magazines - available in
bookstores or alternative medicine journals - that mimic a peer-reviewed study
format. These can be deceptive and flawed, Flamm said. Examine researchers' credentials. Look at qualifications
such as M.D. or Ph.D. One red flag in the Columbia case was a
"researcher" with J.D. (doctor of jurisprudence) after his name. Watch out for hype. Scan the abstract and introduction for
tell-tale jargon that suggests an unscientific approach or quackery. The
phrases include "revitalizing the body's energy," "miracle cure
for weight loss," "guaranteed antidote for menopause symptoms"
and "groundbreaking treatment against ..." "These should stop you in your tracks," Flamm said. The Columbia researchers claimed that women at a South Korean hospital were
twice as likely as others to conceive if, unknown to them, Christian strangers
thousands of miles away uttered prayers on their behalf. Extraordinary claims call for extraordinary evidence, Flamm said. "And never in the history of science has a miracle cure ever been
proven," he contended. Study the methodology. Good controlled studies don't rely
on anecdotal evidence and testimonials. Instead, they use statistical analysis
of results based on a large sampling of people tested under rigorous
conditions. The most rigorous methods are randomized, meaning that patients are
assigned to a study group or a control (placebo) group in a way akin to a coin
flip. A double-blind clinical trial is the least biased: Neither the researchers
nor the patients know who receives the placebo or the drug being tested until
the end of the study. "The Columbia study was an exception," Flamm said. "It had
all these features and was approved because people at the school and the
journal dropped the ball. Had it been true, it would have changed the entire
way we practice medicine." Reach Mike Schwartz at (951) 368-9591 or mschwartz@pe.com.
http://www.pe.com/lifestyles/healthandfitness/stories/PE_Fea_Daily_prevent824.eca9.html