Interesting Article

[Abbax8]

http://www.slate.com/id/2150354/?GT1=8592

Peace

Dennis

[jwinch2]

Unfortunately, I see this all the time. People misinterpret the research, or misreport it for their own benefit. Often time, the newsies don't know what the hell they are talking about, and the "experts" they hire to talk to them about health issues are long removed from practice. In addition, MD's who are the most often cited sources for these reports, in most cases have absolutely no actual research experience and little if any training in interpretation of research. They do not understand statistical treatments, how to measure effect sizes and impact of a change. This is certainly not thier fault as they are trained to be what they are. They are given one "block" class in interpreting research and in most cases are not required to perform any of it themselves. They are the ones who are responsible for applying it, but more often than not, they are not out developing and interpreting it. However, it is their fault when they are perfectly aware that they are not experts in interpreting research, and they do not acknowledge that fact prior to making their statements about new studies that come out.

I can certainly tell you from my own personal experience that taking one class on research methods and the required statistical interpretation course did not teach me all that I need to know about reading and dissecting research. Many stats classes later, learning to review articles at the hand of my advisor who serves as an editor for several journals and reviews for even more, and a decent amount of performing my own research has gotten me to the point where I would say that i am "better than I used to be" but by no means an expert.

Just my perspective on the situation... It is a big problem, and one with no easy solution...

Thanks for posting it Dennis!

Jason

[Abbax8]

The article hit a nerve for me as I have observed that just about everyone I know over 40 is on cholesterol meds, bp meds, etc. My ancestors all lived to their 70's and 80's without these wonders of modern medicine while eating meat, fried foods, potatos and imbibing in adult beverages.

Peace

Dennis

[evvad]

In this one case I'm not sure the problem you are speaking of is being showcased as much.

They don't specify what kind of sample was used for the study. Yeah, the drug's statistics don't look that amazing when a random sample is taking them, but most of the people in that random sample may not need the drug. They may be overall a healthy sample.

When the drug is being taken ONLY by people at high risk of heart attack then the % of prevented heart attack will be closer to their statement.
It's not necessarily inflated.

BUT if the people who took part in the study were all at risk of heart attack then I completely agree, in this case.

Do you know what I'm trying to say?

As for how to deal with the problem couldn't it be a simple as standardizing the way in which results are posted in journals (their summaries as well) as to keep people from getting confused? It wouldn't solve the problem but it would help.

Now after all this; I'm not saying I'm for doping everyone with anything. I think the solution to chronic diseases lies more with prevention than treatment. At least that's the only means we have to deal with it right now.

[evvad]

After thinking about this yesterday I withdraw my statements. Not only is that not really what I was intending to say, it's just plain dumb as posted above.

Sorry for hijaking what could have been a good thread. :(

[jailess]

The trouble is that Number Needed to Treat (NNT) and relative risk reduction (RRR) say the same thing - just from different perspectives.

NNT is the data you need to have in your mind when thinking about populations: I have to give 208 people aspirin before I prevent one heart attack.

RRR is when looking at the individual human: If I give you aspirin, your risk of a heart attack is reduced by X%.

They both say the same thing; one is tailored to the individual, the other is useful for planning treatment of populations (e.g. the population in the UK who have had a heart attack).

You're right, Dennis, in that the absolute risk reduction to the individual is slight. But we don't know which people it's worth giving the drug to. So, empirically, we have to give them to everyone (in a target group).

I know how you feel about overmedicating people - my Dear Old Auntie is over 90 now and still on a cocktail of drugs (I'd take her off them tomorrow if I could - I don't see the benefit of prolonging the life of someone who's lived 12 years past the mean life expectancy). But the alternative is to say to people, "Stuff you, I'm not giving you any drugs, cos there's a good chance it'll make no difference anyway." Not what they want to hear from their doctor.

One last thing: this sentence:

Are you thinking of taking aspirin to help avoid a heart attack? The NNT is a lousy 208
Makes me think whoever wrote this article doesn't know what they're talking about: An NNT of 208 is really very good. That's why we use aspirin all over the world as a preventative measure. Generally speaking, and NNT of under 500 is considered a good result.

[Abbax8]

I admit to being biased against the current trend in medicine where TV ads are evenly split between "talk to your doctor if you have any of these syptoms" or "you can be part of a free trial" these being followed a few months later by "have you or a loved one sufferred harm in any of the following ways while taking Drug X, if so our lawyers want to talk to you".

Peace

Dennis