Today it seems that we're bombarded with news about some great new medical hope or fear of the moment, and I worry that we are all suffering from health-information overload. Fortunately, there are a few simple steps we can take when reading medical news that will help us to put it all in perspective.
First, is a story based on a handful of examples, such as adverse reactions to a drug, or does it cite stronger evidence? In science one early, isolated study almost never settles a question. But if researchers are drawing their conclusions by studying the accumulated evidence of numerous trials, that's more useful. Medical research takes time to mature, and it's all about the accumulation of evidence.
Another important thing to look for: do the headline and first few paragraphs match the rest of the story? An example of this involves a story about chocolate and dementia that's been in the media over the past few years. Imagine curing dementia with a chocolate bar!
The problem is, the research suggests it's actually flavanol, a compound in cacao beans, that's getting such wonderful results. While the beans are rich in this powerful antioxidant, the process of making chocolate destroys most of it. People in the study were drinking mugs of hot chocolate or other beverages fortified with high levels of cocoa flavanol. You and I would have to eat 25 chocolate bars a day to achieve the same amounts, according to a Columbia University researcher.
It's understandable if people who read these happy headlines went shopping at the nearest candy store, because most of the stories buried this crucial fact. If you were scanning the headlines and the first few paragraphs, you'd never know the more complex truth.
That's the problem with so much of the health information you get these days. Medical researchers are under pressure to show that they are getting results, and journalists face their own pressures to bring new and exciting stories to the public. We truly live in an exciting time for health research, with scientists learning new things about the human body and diseases every day. But because of these pressures, it seems that every incremental advance is being promoted as the next big cure, and that leads to the fatigue and overload we all feel.
In my work as a family doctor specializing in cancer patients, I see this regularly. People come to me with information they've come across about new anti-cancer treatments or diets. Understandably, they're very excited, and their hopes are high. My heart sinks when I have to disappoint them with the fine print that usually shows the 'breakthrough' research was conducted on mice.
Those stories seldom mention that the majority of mouse research fails to reach clinical trials involving human beings. Of those that do, the majority don't result in a successful drug. In fact, there's a general rule of thumb that once the evidence for a treatment is strong, it takes about 13 years before the drug becomes part of routine care. (Of course, those with advanced disease can receive priority access much sooner through clinical trials.)
That's why I tell people to be savvy readers and look for a few key things in the articles or press releases about new treatments.
First, the absolute minimum is that it has to be what's called a "phase three" randomized trial. Randomized trials are considered the gold standard for testing whether or not a treatment works.
Once a drug makes it to human trials, it must pass through three stages. The first involves a small group of patients to determine dosage and find serious side-effects. If this is successful, the test goes to phase two, where doctors use a larger group to see if the treatment actually works. If the treatment continues to show results, it moves into phase three, where it is tested against existing treatments to find out which is more effective. If a drug has come this far, it's time to start getting excited.
Other things to look for: how large was the sample size? Were the study participants men or women? Does the article caution that the research is 'preliminary' and the authors are calling for more studies? Is the story or press release peppered with words like 'might' and 'has the potential'? And of course, has the treatment ever been tested on humans? Unfortunately, this information is often buried deep in the article. That's why it's important to read it through, and not stop at the headline.
If you're battling a disease or chronic health condition, becoming a savvy reader of medical information will help you to get off the exhausting rollercoaster of elation and disappointment. There are so many reasons to be hopeful about the future of medical research, and I hope this advice can help you put it into perspective.
By Eva Grunfeld
Dr. Grunfeld is Giblon Professor and Vice-Chair Research in the Department of Family and Community Medicine, a Clinician Scientist with the Ontario Institute for Cancer Research, and a Professor at the Dalla Lana School of Public Health at the University of Toronto.