Science By Press Release…….or Churnalism per this article. My eye was caught by the initial headline on my feed (yet another on the recent flurry of banner headlines on melatonin supplements …..not on this site surely!!?!)….so I’m as susceptible as anyone, I guess 
. I don’t know which is more interesting …. the analysis of all those gussied up press releases on the “dangers” of melatonin, or the hyperlink to other articles on SBPR in the opening paragraph.
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A useful article from the start for me as, full disclosure, I’d never even heard of this TriNteX database before, let alone how poor a resource for studies generated from Big Data (AI, even??) it actually is.
My old TMF profile quote is being reinforced every day……'“The more I learn, the less I know”.
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Yep
The family who are doctors and our MD family friends dismiss most “research”.
Two years ago a poster who’s a PhD in some other discipline thought he could read all the research endlessly and be informed. In some ways that is very troubling if you know the general worth of that approach. People need to see trained specialists.
My closest friend believes I am brainwashed. He’s into how bad medical care is. He doesn’t know how good it is.
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Well, in its way, that’s as daft an approach as getting your medical information from the gussied up press releases in popular media outlets. Saves the trouble of trying to stay up to date and be aware of gaps in one’s knowledge base, though, so I can see the attraction.
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You keep making crazy statements.
The reason all of those doctors dismiss most of the research: they scientifically review the research carefully. Upon thinking it over with rationales most of it is dismissed.
You missed the vital steps. Going off and attempting to reproduce those studies……with all the time and effort that involves……submitting said research to journals for publication, playing a waiting game to see if other skeptical research groups come to the same conclusion etc.etc…
See, all these doctors in your family (if your account is accurate) appear to be making the same mistake that the health and science writers who’re acting as stenographers for institutional press releases. That is, treating (original) research studies as if publication is validation. It’s not. Rather, it’s an opportunity for researchers who’ve developed a novel hypothesis and apparently validated it, to open up the books, so to speak, for peers to review, criticique, and test said hypothesis for themselves.
Regardless, the point of my thread opener was to present yet another example of how easy it is for the average reader to be unwittingly bamboozled by the plethora of health information assaulting their eyeballs. Regardless of media outlets for the ubiquitous press release.
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Here’s a great article on this very topic (doctors and research). It’s an old favourite of mine that I’ve reproduced repeatedly over the years on the old H&N board in the context of SBPR. It’s stood the test of time…..and how!!!
How doctors can get behind the headlines - PMC How doctors can get behind the headlines - PMC
Ben Goldacre first crossed my radar screen as an entertaining ….. and more importantly credible ……medical journalist (as opposed to a Health and Science writer) a few years before that via his Bad Science column in The Grauniad, and subsequent online resources. He was one of a handful of such journalists to take on and challenge the media’s love affair with Andrew Wakefield starting long before most folk had even heard the name.
As an FYI, most folk would not have smelled fish reading that initial published case report whilst leafing through The Lancet. It was the subsequent SBPR that gained traction and fueled this current, long lasting wave of anti vaxx sentiments.
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That is mixed. The NIH does not do many studies twice over. Money is not wasted. But things of course have been studied twice. Things often do not hold up a second time around.
Where they are misled, someone has worked hard at the job.
From your link. This is mixed. Misled but not necessarily on purpose. Most PhDs are not Doctor Oz. It is not that profitable. Worked hard, yes, I grant them that. Unfortunately misguided endlessly.
It’s not often you’re right @Leap1 ….and you’re wrong again.
Preliminary data /hypothesis testing are never accepted at face value (except by those health and science writers working with press releases). Novel hypotheses are tested….and frequently validated….far more frequently than you are aware of.
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Good thing you can read my mind.
Folk who believe that publication equals validation can be a serious threat to public health. Since I mentioned upstream the SBPR example of Andrew Wakefield and his case study, that would serve as a perfect example.
Since 1998, thousands (hundreds of thousands??) of research dollars have both attempted to reproduce his data (unsuccessfully) and also find a link between the MMR vaccine and autism, using massive databases (equally unsuccessfully) So in an effort to find a few of these I stumbled across the CDC website. “Aha!….a trustworthy source!!”, sez I. What was I thinking???
Autism and Vaccines | Vaccine Safety | CDC Autism and Vaccines | Vaccine Safety | CDC
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Peer-reviewed papers are used to update professional medical association guidance. A doctor can use this guidance to update their clinical practice guidelines and protocols.
For example:
“The American College of Cardiology (ACC) has a long history of developing documents (eg, decision pathways, health policy statements, appropriate use criteria) to provide members with guidance on both clinical and nonclinical topics relevant to cardiovascular care. In most circumstances, these documents have been created to complement clinical practice guidelines and to inform clinicians about areas where evidence is new and evolving or where sufficient data is more limited. Despite this, numerous gaps persist, highlighting the need for more streamlined and efficient processes to implement best practices in patient care.”
https://www.jacc.org/doi/10.1016/j.jacc.2022.07.006
Yikes, I would be SERIOUSLY disappointed if my intervention cardiologist (and anyone else’s, for that matter) used this NNT site to inform clinical decision-making and patient discussions.
Updated on statin use in 2013 with studies such as this for guidance???
Primary prevention of cardiovascular diseases with statin therapy: a meta-analysis of randomized controlled trials - PubMed Primary prevention of cardiovascular diseases with statin therapy: a meta-analysis of randomized controlled trials - PubMed
I think most folk might’ve fathomed by now that a study yielding unimpressive results over a period of less than 5 years is to be expected with a disease that can take as many decades to show clinical signs and symptoms.
I also find myself wondering why studies dating to the 1960s were included in this meta analysis when statins weren’t available until the 1980s🤔
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TheNNT link was just a quick example, maybe a poor one. Another example is the USPSTF. The 2022 USPSTF recommedation on statin use was based on 22 trials with mean follow-up of 3.3 years, and was generally consistent with the 2016 recommendation.
The point was that most doctors are not generally basing advice on the latest research papers. Instead they consider recommendations from professional medical groups.
Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication, August 23, 2022
Adults aged 40 to 75 years who have 1 or more cardiovascular risk factors and an estimated 10-year cardiovascular disease (CVD) risk of 10% or greater.
Recommendation: prescribe a statin (Grade B).
“This recommendation replaces the 2016 USPSTF recommendation on statin use for the primary prevention of CVD and is generally consistent with that recommendation… The USPSTF reviewed 22 trials that reported on the benefits of statin use for primary prevention. Mean duration of follow-up was 3.3 years.”
The standards of care are formed by research. The standards of care are carefully followed. The standards of care are often wrong and changed.
Dad explained on one occasion going to the standards board with a protocol he formed for only one patient that would not be permissible as anyone else’s treatment. He legally had to get their ok.
Maybe??? Well, I guess it depends upon the purpose of looking for…..and presenting….. the statistics quoted.
The thread start was primarily intended to highlight just how easy it is to bamboozle the unwary via press releases etc (intentionally….or otherwise) …..and to suggest we’re all at risk of bamboozlement. I used the anti vaxx movement as an example because it is quite topical and likely to become more so given the recent changes to CDC policy. Cholesterol denialism and statin phobia are similarly ripe for such misrepresentation. Additionally….in case my intention was somewhat hazy….I was more focused on information that individuals use in personal decision making not how physicians gain their information.
As I believe I mentioned/hinted at upstream, it’s a mistake for anyone to imagine that a seemingly unimpressive benefit profile for statins (these meds seem to be a focus here) over a sub 5 year period means that “statins don’t work” or that the risk:benefit ratio is unfavorable for use. I have seen this before, BTW so I’m not necessarily implying that was your intent.
This might, however, be exactly the sort of information presented by a patient to their physician that Ben Goldacre was writing about in the BMJ article I linked to. Not incorrect data in and of itself, or a reflection of patient ignorance/stupidity but rather a lack of appreciation for statistical analysis (a very dodgy area for my understanding and experience)…..or in the case of hypercholesterolemia and statin usage, the pathophysiology of cardiovascular disease (unfortunately, not such a dodgy area of my understanding and experience)
See, a modest gain over a sub 5 year period with a disease process that can take as much as 5 decades to develop to level of clinical significance, can translate to a big effect on primary prevention. This is the case with statins…..and the benefit is greater the earlier it’s begun (depending upon the risk profile) Not unlike modest saving programs in preventing penury in ones senior years, or diligent brushing and flossing in preventing periodontal disease
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The OP article defines “churnalism as the careless, incurious reporting of poorly conducted biomedical research”.
In a nutrition class I took over 40 years ago, I learned to be highly skepical of any nutrition news article that stated a “study shows”. Studies are often misleading or produced for ulterior motives (e.g. publish or die). The OP article adds more criteria for discerning readers:
“Failure to identify a plausible reason why melatonin causes CV disease should signal to readers that the findings should be ignored.”
“Because it is more likely than not for medical research to use unreliable data sources, readers of the literature should ignore any research findings that are not associated with reporting of the data source’s quality.”
“The modern medical journalist tends to field press releases and write articles based on what is in the release, with little in-depth investigation.”
“When deciding what to trust in science reporting, look for the articulation of a study question, why that question is plausible, how the data represent the phenomenon being studied, and that the data truly represent the phenomenon being studied. Ignore reporting that lacks this sort of discussion or, worse yet, simply wants you to uncritically accept the headline assertion.”
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The AHA used the alarming headline:
“Long-term use of melatonin supplements to support sleep may have negative health effects”.
This was based on a unpublished preliminary study that cannot prove a cause-and-effect relationship. A better headline might have been:
“Research needed: Does melatonin increase rates of heart failure?”.
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That nutrition class I took over 40 years ago also said to avoid trans fats, but the FDA did not ban artificial trans fats in food until 2018. Staying informed and being actively engaged in your health decisions is important (e.g. avoid trans fats), particularly when ulterior motives may delay government action (food manufacturing was easier with trans fats). But beware of studies.
The Demise of Artificial Trans Fat: A History of a Public Health Achievement, 2021 Aug 3
“In the 1950s, clinical studies provided the first evidence that partially hydrogenated fats raised blood lipid levels. …
In 1980, a questionnaire designed to assess the major sources of trans fat in the diet was sent to a prospective cohort of more than 90,000 women, the Nurses’ Health Study. A decade later, the researchers found that women who consumed the most trans fat (5.7 grams/day) had a 35% higher risk of coronary heart disease (CHD) than did women with the lowest intake (2.4 grams/day).
Throughout the 1990s, evidence of the harm of trans fat grew. Three additional prospective cohort studies also linked higher trans fat consumption to an increased risk of CHD. Longer follow-up data from the Nurses’ Health Study confirmed the initial findings, demonstrating that the participants’ higher intake of trans fat, ascertained through food frequency questionnaires and blood samples, predicted a higher risk of CHD. Together, these studies found a 23% higher risk of CHD for each 2% increase in energy intake from trans fat. An additional analysis of prospective cohort studies concluded that consumption of trans fats was linked to significantly elevated risks for all cause mortality, CHD mortality, and total CHD incidence. …
Responding to strong advocacy from its nutrition research community, Denmark effectively banned artificial trans fat from its food supply in 2003. …
In 2015, following a period for comment on its proposal, the FDA revoked the GRAS status of PHO, giving industry three years to eliminate it.”
File under if you get enough things wrong and start to clear out the wrong?
But there is more to get wrong first on the horizon.
A gift from another thread to file under this heading……
‘Ozempic Personality’: How Weight Loss Drugs Can Affect Your Behavior ‘Ozempic Personality’: How Weight Loss Drugs Can Affect Your Behavior
Reading through the article, I was struck by the profound difference in the academic qualifications (fitness to be quoting on the topic?) of the article author and fact checker and the experts on the topic quoted within. It was apparently persuasive enough for the moniker to achieve some sort of archival status, though🤔
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