Rarely does a day go by when a patient or family member does not ask me about a medical news story. In fact, I am frequently asked about breast cancer trials the day after they make the news!
I firmly believe that education, whether self-directed or from a reliable healthcare resource, is critical to enabling patients to make informed decisions about their health and treatment options.
This being said, there are several things I frequently find myself reminding patients as they wade through the enormous amount of medical information, and I thought I’d share a few examples on this blog:
1. Is it from a reliable source?
This is the most important first step in examining any medical news or trial. There is a lot of information out there, whether you hear of it by word of mouth, on the radio, television or internet.
Always consider the source. Trials reviewed from major news organizations, national medical groups or societies, or published in major medical journals are usually the trustworthiest.
Blogs from major healthcare providers, (like the one you’re currently reading), are also a great source of expert information. On the other hand, if you’ve never heard of the source before, that’s probably a bad sign.
2. If this is a new clinical trial, what type of trial is it?
It is important to understand the difference between “prospective” and “retrospective” trials:
- Prospective trials
Generally, prospective trials are designed to gather information and results going forward, and tend to produce more reliable results because the questions the researchers are asking are defined and data is carefully collected from the beginning.
- Retrospective trials
Looking back at data gathered before the “question” was asked is called retrospective research, and such research is generally considered less reliable for several reasons.The principal reason for this is ‘looking back’ to find a correlation doesn’t ensure that a relationship is ‘causative.’
For example, eating ice cream cones may be correlated with dehydration, but people may actually buy more ice cream cones during hot weather and the hot weather may actually lead to dehydration.
In addition, observers ‘looking back’ and interpreting what has happened can have biases towards classifying outcomes.
Selection bias refers to errors in choosing which patients or groups to include in a study. Information bias is error(s) in classifying the results themselves.
Significant medical knowledge still comes from retrospective research, but it has its limitations.
3. Does this information apply to me?
As the body of medical knowledge has rapidly increased over the past 50 years, many of the questions addressed in modern research are answering very specific questions about specific patient populations. While the results of new medical research may apply to you, it is important to avoid overgeneralizing results from these specific trials to “all patients with this disease.” If you are not sure if the news or trial applies to you, ask your doctor.
4. What is the ‘take home message’?
Frequently the most important conclusion or educational point from a trial is in the title, headline, or conclusion of the abstract. However, sometimes a small difference in a patient’s experiences or outcomes makes headlines and the “big picture” gets lost in the debate.
In typical media or news reports, look for expert commentary from doctors or other healthcare providers, who frequently try to explain the important findings being reported in simplified language. Again, if you’re not sure what the “take home message” is, ask your health care provider.
5. What details were not reported or overlooked?
This is probably the most difficult aspect in understanding a medical trial that has been reported — and it is what I spend the most time considering when reading medical journals and articles.
Most peer-reviewed articles do list their research’s weaknesses and limitations, but you need access to the published journal article to read them. If you are reading a news article, note if the journalist or author mentions the weaknesses or doubts concerning the research. If they don’t, again, consider the source or dig deeper.
6. How should I discuss this with my doctor(s)?
This one is simple: Just do it! Physicians should be happy to discuss evidence-based medicine with their patients, and you should not feel shy or hesitate to ask your doctor about if, how, and why emerging research concerning your health applies to you.
Keep the above points in mind, and remember that learning is a life-long endeavor for you and your physicians.