Medical information, including health care information on diet, exercise, cancer, heart disease and so forth is available to everyone. Hundreds of thousands of studies are published every year in journals and articles released to the press yearly. This fact, seems to suggest that the information we get from the news, blogs, and dozens of other sources is reliable and timely and will help to save many lives etc. Unfortunately, this may not always be the case. I will discuss how a prominent health care information scientist is suggesting that the information we get about health care daily may in fact be primarily wrong (for more information please see the original article at http://bit.ly/h5KZQA).
Scientific evidence has been generated all over the world for almost all ailments that affect mankind for years and years now. Larger and larger, better designed studies are the norm now. More and more information on health care is accessible by every day people now more than ever before. The data underlying the conclusion that are made very day is not wrong nor is it right. It is data. However, unfortunately the conclusions themselves may or may not be accurate. In fact, Dr. John P.A. Ioannidis, at the Stanford University Prevention Research Center feels that most of the conclusions that are made from the data that is shared to the public may in fact be wrong. Not just a small amount butr perhaps almost all of it. That is scary, as many people, including myself buys into the ideas that are promoted by the medial
Why does he believe this and why am I a supporter of his ideas? In the US right now, health care policy makers (such as insurance companies) are trying hard to save costs as the US tries to implement a semi-universal health care coverage agenda. In order to do this, economists and policy makers turn to claims made in the literature and by companies that suggest only certain treatment work for certain people in certain conditions. However, the claims that are made in the literature and by the companies who sell the products in the first place are actually often wrong. For example, Dr. Ioannidis looked at both Vitamin D for preventing bone disease and Statins such as LipitorTM in preventing heart disease . In both cases, new huge studies that were done with little influence by the makers of Statin and Vitamins concluded that neither prevented heart disease nor bone disease and were not necessary as a preventative agent. These results if acknowledged by the medical community can save BILLIONS of dollars on unnecessary prescriptions per year. As you can imagine, the makers of Statin drugs and vitamin manufacturers are not happy with the news. I think it should be clear to you why there is some inherit bias in medical studies and why conclusions are often made that are not supported by evidence sometimes….that is that money often drives decisions not facts.
I do not wish to pick on these two industries as it turns out that the entire drug trial industry may be at fault. In fact, Ioannidis has found that the majority of conclsuions made by drug trials about the efficacy of the drug in questions are often wrong….most of the time. One reason for this is that is it virtually impossible for anyone to publish negative data. More time than not in research, one gets no data (or negative data) and does not publish it (because no journal will take it). Thus, no one knows if a drug is NOT effective as that information is not released. The company will either bury the study and mark it down as a waste of time, or they will slowly change th outcomes of the way the data is collected or just prolong the study until the negative data turns positive. Very often the positive data is so weak and so anemic that the significance of the positive data is only slightly better than the negative data that existed before it . These clinicial trials that drug companies must use in order to show safety and efficacy are extremely expensive…costing hundreds of millions of dollars. There is HUGE pressure to make sure these trials give positive data.
Another reason that Dr. Ioannidis gives is that in many cases the statistics used are shoddy. This is either intentional in order to make the numbers (within the data) look good or simply by using the wrong statistical tools on the wrong data sets. Often, the statistics that are used to not really lead at all the conclusions that are reached or they don’t have the right ‘power’ to make those conclusions. Now, many previous studies have been called into question and Dr. Ioannidis and his teams have started analyzing large studies using their own statistical tools and have found that many many overstated claims. For example, the link with Vitamin E and heart prevention in not accurate, PSA as a way to save lives as a screening tool, now seems false and so on (for Prostate Cancer). The list goes on and on. It seems fashionable now to have newspaper promote their own scientific researchers (in Singapore this is often done) by informing the public that his/her studies are changing people lives or about to revolutionize treatment etc, in one way or another. All sorts of untested ideas are floating around at dizzying speeds in articles by newspapers, blogs, etc. Doctors and other health care professionals have to be careful and ignore most of these as they are usually 100% baseless. We are lay people need to be very careful to listen but not swallow whole what we read from the newspapers.
Thanks for reading my current rantings. For more information about cancer in general please do see Cancer Made Simple!