Wednesday, October 27, 2010

Bacon, Baklava and Barium

You know the story of the blind but wise persons put into a room and asked to describe the animal in the room with them using only touch to identify the beast. One person touches the elephant's trunk and another the tusk, the tail, the ears etc. We end up with a lot of very different descriptions of the elephant, none of which resemble the actual creature. There are several morals to that tale about insufficient information, anecdotal evidence, knowledge versus description, getting the whole picture, turning water into wine and not cutting babies in half to satisfy competing parents. Teaching parables have been used since dolphins could first communicate.

Imagine this twist in the tale, the wise persons are not blind, they are all put in front of a huge salt water coral reef tank in one of the wonderful aquariums we have built around the world. Their task: describe one of the tropical creatures they see. Of course you would expect to get a wide range of reports with all of the brightly coloured sea life on display. But then I tell you that at least one of the reports came from a man wearing those blu-blocker sunglasses, another from a women who turned her back to the aquarium and described only what she heard murmured by others and finally, one of the reports came from a man paid to describe only the yellow and white, heavily spined pufferfish. What distorted moral would you draw from this tale?

An article this month in The Atlantic suggests that this little fish story is the moral equivalent of medical research today. Lies, Damned Lies and Medical Statistics reports via meta-research that the data being given to doctors and patients about diet, exercise and in particular pharmaceuticals is terrible flawed and potentially bought and paid for by the drug manufacturers.

Here some excerpts:

Can any medical-research studies be trusted?

That question has been central to Ioannidis's career. He's what's known as a meta-researcher, and he's become one of the world's foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies--conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain--is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field's top journals, where it is heavily cited; and his is a big draw at conference. Given this exposure, and the fact that his work broadly targets everyone else's work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the filed of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change--or even to publicly admitting there is a problem.

No here comes the scary part--Dr. Ioannidis is not being scapegoating or attacked, nearly everyone segment of the medical research community agrees with his findings, but they are not sure they should tell--us!

The question of whether the problems with medical research should be broadcast to the public is a sticky one in the meta-research community. Already feeling that they're are fighting to keep patients from turning to alternative medical treatments such as homeopathy, or misdiagnosing themselves on the Internet, or simply neglecting medical treatment altogether, many researchers and physicians aren't eager to provide even more reason to be skeptical of what doctors do--not to mention how public disenchantment with medicine could affect research funding.

I strongly recommend reading the entire article. After I finished it I thought about the several medical newsletters I regularly read online and wondered how much of that information is flawed. Never mind, how much has changed, even completely reversed the health advice we received in the recent past. I thought I would offer up some of my favor current bits of medical wisdom with Dr. Ioannisdis' caveat that it is likely to be flawed, wrong or bought and paid for.

*Hair loss before age 30 is associated with a lower risk of prostate cancer later in life, according to a new study that contradicts some earlier research.

*A new study shows foods high in fat and refined sugar can create a cocaine-like addiction that leads to obesity. Persons so addicted should be treated for their addiction before attempting to address the weight issues.

*That daily baby aspirin for heart health, you know the one that suddenly became a full 325 mg tablet a couple of years ago. Well now it may not be such a good idea, particularly if you have a predisposition to stomach bleeds.

*Water--yes water! It seems those eight glasses of water a day are not such a universally good idea. Not only are there kidney issues for some individuals but when you drink the water can have an absorption/dilution effect on many medications including your Flintstone vitamins.

*Sex remains a good outlet for nearly every one. For the very few who might have serious life threatening consequences -- you got a better way to go?

**Yes I know that's a rhinoceros not an elephant, but a cool sculpture none the less.

1 comment:

SirFWALGMan said...

i knew water was bad! I hate water!!!!!!!!!