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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