Wednesday, April 29, 2015

Making Sense of Medical Studies and Getting the Most Out of Them for Your Health


Recently, I wrote an article detailing the studies on coconut oil and heart health and was flooded with feedback. A lot of feedback was positive, leaving many individuals enlightened on a topic they may not have known about, some was neutral (or positive) showing reinforcement for what readers already knew, and some was filled with uncertainty, confusion, or even downright disdain for the write-up.

Below, I share a couple of the comments received, both positive and negative, to set the stage for this article:


Facebook comment: “Thank you! I've never bought the hype.

Email response from a reader: Email subject – “You are full of s#!@.”; Email body – “Your 'article' about the dangers of coconut oil TRULY SUCKS!  How dare you put such lies out there for ignorant humans to read and possibly believe?  Try doing something worthwhile--like telling the truth!

Emotional vs. Analytical Thinking in Science and Medicine


Obviously, my article stirred a lot of emotions in people, both positive and negative. In a way, this is a good thing, because, at the very least, it conveys the message that people care about their health. They also care about the food they eat and how that food affects their health.

There is a lesson to be learned in this though. That lesson is… that our emotional responses (and how we act upon them) to scientific facts can either be helpful or harmful to us. Thinking with emotions when it comes to science can actually be worse than guessing in terms of health outcomes.

Here’s an example of what I’m talking about. In the 1840’s, a Hungarian obstetrician by the name of Dr. Ignaz Semmelweis observed that hand washing could save lives by preventing the spread of infectious diseases.1 He made this observation by noticing mortality rates between two adjacent birthing clinics. One clinic had a morgue in it, and physicians would transition between doing autopsies and delivering babies without washing their hands. In this clinic maternal deaths were much higher than in the adjacent clinic, which did not contain a morgue and only housed a birthing center.

When Dr. Semmelweis spoke up about this his colleagues became enraged and insulted. How dare he criticize them for their good work! Besides, the current scientific and medical opinions were to the contrary of what Dr. Semmelweis was proposing at the time.

Because these doctors were too wrapped up in their old belief systems and emotions, patients suffered and died. Emotions ruined lives in this case. Guessing would have proven more effective given the 50/50 chance that choosing the implementation of hand washing in both clinics would have saved lives.

The point I’m trying to make is this - Science is best approached using analytical thinking, not emotional thinking. When we get engrossed in our feelings about a subject in science, it clouds our ability to think critically about the facts laid out before us. Good judgment is likely to elude us in these cases, unless we just so happen to guess right using our emotions. But who wants to take the chance of guessing right when there is a more effective way to come up with a solution to the problem?

If you find yourself emotional about a topic discussed in an article you read or news story you hear then take a step back, breathe deeply, and think about returning to the subject at hand with an open mind. This way, you can refocus and use your critical thinking skills instead of your emotions to decipher what is being said. You don't have to agree with what is being said, but you do need to think logically and objectively about the information given.

Learning How to Decipher the Scientific Literature


Another topic I wish to discuss is the process of being able to accurately decipher the scientific literature. I know this sounds like a daunting task, but hear me out.

I can’t tell you how many times I’ve heard the following comments and questions over the course of my career:

“I don’t know what to believe now. It’s all so confusing!

“There’s a study to prove everything. Who’s telling the truth?”

“Everybody has a different story on this topic. How do I know who to trust?”

“One day the news says _____ is good for you, then the next day they say _____ can kill you. I give up! I’m just going to keep doing what I always do.”

Sound familiar? I’m sure you can relate. I, too, found myself in this crowd for a long time, even after graduating pharmacy school. Sometimes, I still find myself in this crowd. Nobody is perfect. Nobody is all knowing, and don’t feel bad if you feel stupid or stumped by a topic that seems like it should be straightforward. We’ve all been there.

Instead, view this as an opportunity to grow. Grow in your ability to accurately sort through these ‘confusing’ or ‘conflicting’ moments regarding science and medicine. After all, it is YOU who benefits the most by doing this.

How do you do this?

That’s the tough part. This requires work and effort on your part. Remember, nothing worthwhile in life comes easy, but it’s certainly worth the reward in the end if you choose to do your homework.

You have two choices when it comes to deciphering medical and scientific studies – put the work and effort into learning what ‘all those confusing studies’ say yourself, or take a chance at trusting whomever it is you choose to trust in reporting the studies to you. The latter is not a bad choice, as long as you find the right individuals to follow. Pay attention to their results though. Remember, it’s easy to talk the talk, but walking the walk and producing actual health outcomes is different. Not everyone can back up what they say.

If you do feel motivated to tackle the scientific literature for yourself, I have a few suggestions that may help you along the way:

1) Read the Actual Studies
  • You have to read the scientific and medical studies to properly assess them. Don’t rely on others to do this for you. I often find myself looking up the references cited at the end of articles written on the internet, even in articles written by my own mentors and icons in the healthcare field. This is how you learn who to trust, by doing the digging yourself.
  • Search for studies on Pubmed.gov, GoogleScholar, or Tripdatabase.com. These resources are free searchable databases of the scientific literature. Not all journal articles one these databases are free, but many times you can find their summaries if the full-length article is unavailable.
  • Download the app ‘Read by QxMD’ for access to journal articles on your smartphone. Again, not all articles are free, but many have summaries if their full-length versions are unavailable.
  • Use the Medline Plus health/medical library search website (www.nlm.nih.gov/medlineplus/libraries.html) to locate a medical library close to you. Many times these libraries will have full-length journal articles available for free if you use them. They also have librarians who’s job it is to assist you in your search for answers. All you have to do is ask for help.


2) Take a Course in Statistics
  • Understanding statistics cannot be overstated enough. If you want to understand the difference between types of studies, how they’re designed and carried out, or how results are reported within the studies you need to at least have a basic understanding of statistics. By doing this, you’ll be able to better evaluate the credibility and quality of the data you’re reading.
  • Your local community college may have available courses in statistics.
  • Here are some excellent FREE courses on statistics available at KhanAcademy.org or TheOpenAcademy.com.
  • Learn from a group of physicians called theNNT.com how statistics are reported in studies.


3) Learn Basic Anatomy and Physiology
  • In order to understand medical and scientific studies you need to at least have a basic understanding of how the human body works. For instance, if you’re reading a study on heart health and nutrition then you need to know the basics on how the cardiovascular system works—the heart, the blood vessels, the blood, and so on.
  • Your local university or community college may offer A&P courses.
  • There are some well-done FREE courses and lectures on A&P on the KhanAcademy.org and TheOpenAcademy.com.
  • There are also some free medical lectures entitled ‘Mini Med School for the Public’ presented by UCSF Oshner Center for Integrative Medicine here. Many of these lectures are done by physicians on various medical diagnoses in the human body and are presented in relatively simplified layman’s-term-type style. While these lectures provide a lot of useful information from the conventional side of medicine, they do fall short of presenting the best available evidence to date on nutrition and health so please keep this in mind when watching them.


4) Practice, Practice, Practice
  • In order to get good at anything you need to practice it over and over again. Repeat steps #1, #2, and #3 to hone your skills in accurately deciphering the scientific and medical literature. Soon you’ll no longer be “confused” when reading different articles on the internet or watching conflicting news reports. Or, at the very least, you should be able to think objectively and critically about the information presented to you. Remember, the onus is on YOU to get your health right, not your doctor or pharmacist or random health blogger. In the end, you benefit the most by being proactive, involved, and well informed in your own journey towards optimal health.


Summary


I hope you’ve found this article helpful. It is my goal to help you cut through the confusion that often presents itself in the medical and healthcare fields, whether this comes to you via the news, on the internet, or anywhere else you get your information from.

This can be a difficult task, especially if you don’t know where to start. Hopefully, with the tips and resources given to you here, you now have that starting point. All that’s needed now is to take advantage of this and hit the ground running.


Good luck!








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by Dustin Rudolph, PharmD
Clinical Pharmacist

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References:
1 Noakes TD, Borresen J, Hew-Butler T, et al. Semmelweis and the aetiology
of puerperal sepsis 160 years on: an historical review. Epidemiol Infect. 2008

Jan;136(1):1-9.

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