When Almost Everything You Hear About Medicine Is Wrong: Who Can Parents Trust?Dana Rousmaniere
I came across this article on Newsweek a few days ago, and thought: “Thank you! Finally! Someone is seriously talking about the schizophrenic nature of breaking health care news in this country. Author Sharon Begley writes:
“If you follow the news about health research, you risk whiplash. First garlic lowers bad cholesterol, then—after more study—it doesn’t. Hormone replacement reduces the risk of heart disease in postmenopausal women, until a huge study finds that it doesn’t (and that it raises the risk of breast cancer to boot). Eating a big breakfast cuts your total daily calories, or not—as a study released last week finds.”
This kind of flip-flopping on health care news can be especially scary for new parents. One day you’re giving your three-year-old cough medicine because you think it’s the right thing to do to give your child some comfort, and the next day’s headlines are warning that parents should never, ever give over-the-counter cough medicines to kids under 4.
What’s a parent to do? Ignore the news altogether and rely on your pediatrician’s advice? Maybe not, as this Newsweek article states: Our physicians themselves are influenced by the very studies that are causing all the whiplash news stories. Begley writes:
“The very framework of medical investigation may be off-kilter, leading time and again to findings that are at best unproved and at worst dangerously wrong. The result is a system that leads patients and physicians astray—spurring often costly regimens that won’t help and may even harm you. It’s a disturbing view, with huge implications for doctors, policymakers, and health-conscious consumers.”
According to one of medicine’s top mythbusters, Dr. John P.A. Ioannidis, the new chief of Stanford University’s Prevention Research Center, “”People are being hurt and even dying” because of false medical claims, he says: not quackery, but errors in medical research.” The article states that “If Ioannidis is right, most biomedical studies are wrong.”
Even a cursory glance at medical journals shows that once heralded studies keep falling by the wayside. Two 1993 studies concluded that vitamin E prevents cardiovascular disease; that claim was overturned by more rigorous experiments, in 1996 and 2000. A 1996 study concluding that estrogen therapy reduces older women’s risk of Alzheimer’s was overturned in 2004. Numerous studies concluding that popular antidepressants work by altering brain chemistry have now been contradicted (the drugs help with mild and moderate depression, when they work at all, through a placebo effect), as has research claiming that early cancer detection (through, say, PSA tests) invariably saves lives. The list goes on.
What’s the driving force behind all the bad medical information? Surprise: Drug companies! Case in point:
“In November a panel of the Institute of Medicine concluded that having a blood test for vitamin D is pointless: almost everyone has enough D for bone health (20 nanograms per milliliter) without taking supplements or calcium pills. Cost of vitamin D: $425 million per year.”
The Newsweek article states that when Ionnidis was working at the NIH, he had an epiphany: “Positive” drug trials, which find that a treatment is effective, and “negative” trials, in which a drug fails, take the same amount of time to conduct. “But negative trials took an extra two to four years to be published,” he noticed. “Negative results sit in a file drawer, or the trial keeps going in hopes the results turn positive.” With billions of dollars on the line, companies are loath to declare a new drug ineffective. As a result of the lag in publishing negative studies, patients receive a treatment that is actually ineffective.
Ionnis also points to statistical flukes in studies, where drug companies are “making a mint:”
Statistical flukes also plague epidemiology, in which researchers look for links between health and the environment, including how people behave and what they eat. A study might ask whether coffee raises the risk of joint pain, or headaches, or gallbladder disease, or hundreds of other ills. “When you do thousands of tests, statistics says you’ll have some false winners,” says Ioannidis. Drug companies make a mint on such dicey statistics. By testing an approved drug for other uses, they get hits by chance, “and doctors use that as the basis to prescribe the drug for this new use. I think that’s wrong.” Even when a claim is disproved, it hangs around like a deadbeat renter you can’t evict. Years after the claim that vitamin E prevents heart disease had been overturned, half the scientific papers mentioning it cast it as true, Ioannidis found in 2007.
What’s the takeaway for parents, if you can’t trust the research, and your doctors are relying on the research to treat your kids? Begley says: Trust conventional wisdom. Trust the methods that have proven themselves over time. Ignore the newsflashes. It’s a safe bet that today’s breaking health news is just a flash in the pan.
Here’s the full Newsweek article.