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Conflicting research studies: how do I know what’s true?

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Consumers often express frustration with new research findings reported to them by the media.  One day a medicine is being promoted on TV as the cure for arthritis pain, the next it is being removed from the market by the FDA, citing increased risk of death.  One day margarine is considered a healthy alternative to butter, the next day trans fats are being banned from entire states.  And so medical research is eyed with suspicion and people are left to wonder about the safety of their food, medications and treatments.

I sympathize with the confusion and frustration.   Here’s part of what fuels it:

1)  Clinical trials are designed to answer very specific questions under a set of limited conditions. They have to be designed this way in order to prove a cause and effect.  The results should be repeatable, given the same conditions.  Sometimes when a drug is used in a different way (like, at a higher dose or for a longer period of time, or in older patients) it has different or more frequent side effects.  It’s important not to generalize efficacy or safety to use cases outside those tested in a clinical trial.  What’s good for the goose is NOT necessarily good for the gander.

2)  Large observational studies can often pick up trends that might not have been noted in a clinical trial. This is why previously unknown (or rare) side effects are sometimes detected after clinical trials seem to indicate that a drug or treatment is safe and effective.

3)  We are all tempted to over-simplify research data, especially the media. How many of us would like to read a headline that says, “Drug X may reduce your arthritis pain by 10% if you are over 80, have no history of high blood pressure or diabetes, use it 3 times a day at 10mg doses and take it on an full stomach” versus “Drug X can cure your arthritis!”  Yup, we just want something easy to understand, and so we opt for statement #2, even though it’s not accurate.  Inaccurate statements generate a lot of confusion and lead to unwarranted hype.

So, what is a consumer to do? My opinion is that the educated consumer’s best friend is an educated physician.  Doctors are natural skeptics – they are formally trained (for a minimum of 7-10 years at good schools) to understand the limitations of research studies and effectively communicate all the caveats that are so critical for informed decision making.  If you’re having a hard time figuring out if a drug or treatment is right for you, ask your doctor (wow, did that sound like a TV ad!)  Or better yet, keep reading the physician blogs and medical news commentary at Revolution Health.  We are committed to translating research news into a format that you can understand and use.  We’ll do our best to cut through the hype and give you the real facts.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Understanding introverts

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Here’s an excerpt from a timeless essay in the Atlantic Monthly about understanding and appreciating introverts. For the full article, click here.

“Extroverts are energized by people, and wilt or fade when alone. They often seem bored by themselves, in both senses of the expression. Leave an extrovert alone for two minutes and he will reach for his cell phone. In contrast, after an hour or two of being socially ‘on,’ we introverts need to turn off and recharge. My own formula is roughly two hours alone for every hour of socializing. This isn’t antisocial. It isn’t a sign of depression. It does not call for medication. For introverts, to be alone with our thoughts is as restorative as sleeping, as nourishing as eating. Our motto: ‘I’m okay, you’re okay—in small doses.’”


This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

Why are hospitals so ugly?

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I used to believe, quite naively, that hospitals were depressing places simply because no one had noted the connection between environment and recovery. It seemed that white walls, antiseptic scents, and cork boards were somehow required of hospitals – and no one had bothered to imagine anything different.

I thought that the solution was fairly simple – get some creative minds to come in and make recommendations for change. So one day I called the chair of the department of interior design at Parsons School of Design and asked whether she might send her students to my hospital to consider how to improve our situation. She was intrigued with the idea – and we soon had an entire team of bright young designers measuring the floors and windows, considering the limitations of our square footage, and getting to work on some dramatic proposals for exciting change.

Several months later the Parsons students made a presentation to our hospital’s executive team, and this was met with great enthusiasm. We all thought that we were on the verge of an exciting breakthrough for patient wellness. But alas, in the end not a single design suggestion was implemented as our administrators told us that there was no money available for environmental improvements.

I found out much later that our acting CEO was making about ½ million dollars per year in salary at the time. All the while the poor patients had to recover in a grim void of sensory stimulation.

There is ugliness in hospitals – and it runs deeper than the white walls. As with many sectors, money is the deciding factor regarding whether or not something gets done. I think that hospitals should take a hard look at their white walls, and the white linings of their executive pockets and ask themselves whom they were built to serve.


This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.

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