Saturday, January 18, 2014

Health Research: How Reliable is it? What can you do?

This past week National Public Radio (NPR) aired two interesting articles relating to the reliability of research and its impact on patient care. Blood Pressure Ruckus Reveals Big Secret in Medicine reported that new blood pressure guidelines for those 60 or over should have a systolic blood pressure (the top number) goal of 150 or less versus the older guidelines that used 140 or less. Which guideline should be used? Is one more reliable then the other?

One answer to this question may be, what does the research show. This brings up the second report from NPR, which basically says scientific research isn’t all it’s cracked up to be. Unfortunately, I’ve been unable to find a link to this news story. However, there is a lot of good reporting on this particular topic. The United Nations Reproducibility, Replication and Fraud in Scientific Research report, starts off by saying, Reproducibility is the foundation of all scientific research. It is the standard by which scientific claims are evaluated. Biomedical research in the US is a 100 billion dollar a year business. Yet, much of the current published data, cannot be replicated/repeated by others even if it is published in so-called top flight peer- reviewed journals. 

The Atlantic article Lies, Damned Lies, and Medical Science  and Gary Marcus article in the New Yorker both provide very detailed information about the quality, or lack thereof,  of medical research. Marcus does try to offer some solutions in his Cleaning up Science article.  And if you really want to be depressed, try Retraction Watch,   where the name says it all.

There are plenty examples of a recommendation for a particular treatment that a few years later become “maybe not so much.” Two examples that come to mind are hormone replacement for post menopausal women and yearly mammograms starting at age 40. Of course there is ever changing research about calcium supplementation, Vitamin D, Vitamin E, low fat diet, cholesterol and much more.

While I could write volumes about this, and there is much you can read on-line, the bottom line is this, we have to make choices regarding our health care that are right for us. Yes, there are major issues with scientific research. However, all the research in the world, no matter how well done, isn’t going to make a difference if the medication doesn’t work for you or it causes side effects that you couldn’t possibly live with.

What you can do:
• Find a provider that you trust and who is willing to discuss things with you.

• Become an e-patient.  Using sites, such as Patients Like Me can give you an idea of how various
treatment protocols are working for others with your condition and it also allows you to share your data. 

• If you choose to try a treatment, follow up with your provider, including lab work, to evaluate if it’s working for you.

• Keep track of how you feel. Does something feel different? Report findings to your provider.

• You can make yourself nuts by reading everything you possibly can. Read enough to make good choices, but not so much that you become overwhelmed and can’t make a decision.

• If you find you’re having a hard time making a choice, check out the Agency for Healthcare Research and Quality’s website Explore Your Treatment Options: It’sYour Health.

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