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Problem In Health News Stories: Therapeutic Misconception

A story in the San Diego Union-Tribune describes testing of “an experimental therapeutic filtering device being developed.”

Think about it. It hasn’t been proven therapeutic yet if it’s still experimental.

Lawyers use a term, “therapeutic misconception,” which is important for everyone to know about and think about. It refers to study participants perhaps having the misconception that the purpose of the trial is, indeed, therapeutic – when that hasn’t been established yet.

I see news stories commit this error all the time. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Can The Delay Between Cause And Effect Lead To Unhealthy Decisions?

We have all seen people exhibit flagrantly unhealthy behavior. Some of us–though we’d never admit it–derive a certain, smug satisfaction by observing them. At least I don’t do that!

Somewhere in the course of our daily lives though, most of us do exhibit behavior that suggests at least some disregard for our health. We don’t change our diet, though we know we should. We don’t floss, take medications as prescribed, or get the screening tests we’re supposed to.

cheesecakefordessert1 200x300 Does Being Diagnosed with a Chronic Disease Improve Healthy Behavior?Multiple intertwining causes underlie all unhealthy behavior, of course. I had always figured that one pervasive cause was the lack of a simple, observable connection between health-related behaviors and health outcomes. There is a long delay for example, between establishing unhealthy dietary preferences  and the sequellae of that behavior (a heart attack, diabetes or whatever). The longer the delay between cause and effect, the more likely someone will be to exhibit unhealthy behavior.

On the other hand, if there’s a short interval between cause and effect—it only takes minutes for susceptible people to develop a severe allergic reaction after eating peanuts, for example—well, that’s where I’d expect high adherence to the required healthy behavior.

If I’m right, then we have a problem. For many chronic diseases (diabetes, heart disease, some cancers) Read more »

*This blog post was originally published at Pizaazz*

Coffee And Stroke: Another Study The Media Got Wrong

Here we go again. Headlines across America blaring lines like, “Coffee may reduce stroke risk.”

It was a big study, but an observational study. Not a trial. Not an experiment. And, as we say so many times on this website that you could almost join along with the chorus, observational studies have inherent limitations that should always be mentioned in stories. They can’t prove cause and effect. They can show a strong statistical association, but they can’t prove cause and effect. So you can’t prove benefit or risk reduction. And stories should say that.

USA Today, for example, did not explain that in its story. Nor did it include any of the limitations that were included in, for example, a HealthDay story, which stated:

“The problem with this type of study is that there are too many factors unaccounted for and association does not prove causality, said Dr. Larry B. Goldstein, director of the Duke Stroke Center at Duke University Medical Center.

“Subjects were asked about their past coffee consumption in a questionnaire and then followed over time. There is no way to know if they changed their behavior,” Goldstein said.

And, he noted, there was no control for medication use or other potential but unmeasured factors.

“The study is restricted to a Scandinavian population, and it is not clear, even if there is a relationship, that it would be present in more diverse populations. I think that it can be concluded, at least in this population, that there was not an increased risk of stroke among coffee drinkers,” he said.”

When you don’t explain the limitations of observational studies — and/or when you imply that cause and effect has been established — you lose credibility with some readers. And you should. Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Ibuprofen-Parkinson’s Study: Few News Organizations Report On It Accurately

We’re delighted to see that USA Today, Reuters, and WebMD were among the news organizations that included what an editorial writer said about an observational study linking ibuprofen use with fewer cases of Parkinson’s disease. All three news organizations used some version of what editorial writer Dr. James Bower of the Mayo Clinic wrote or said:

“Whenever in epidemiology you find an association, that does not mean causation.”
“An association does not prove causation.”
“There could be other explanations for the ibuprofen-Parkinson’s connection.”

Kudos to those news organizations. And some praise goes to the journal Neurology for publishing Dr. Bower’s editorial to accompany the study. His piece is entitled, “Is the answer for Parkinson disease already in the medicine cabinet? Unfortunately not.”

And unfortunately not all news organizations got that message. Because many don’t read the journals, so they certainly never get to the editorials. Instead, they rewrite quick hits off a wire service story. As a result, we end up with some of the following:

A story was particularly deaf to Bower’s caveat, stating: “That bottle of ibuprofen in your medicine cabinet is more powerful than you may think.”

A story never addressed the observational study limitation, instead whimsically writing: “Pop a pill to prevent Parkinson’s disease? A new study says it’s possible, and the pill in question isn’t some experimental marvel that’s still years away from drugstore shelves. It’s plain old ibuprofen.” Read more »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Prevention Magazine’s Inaccurate “Coffee Cures” Story

The September issue of Prevention magazine inaccurately headlines the story ”4 Ways Coffee Cures.” There’s no solid proof that coffee cures anything — unless some of you cure bacon with java, which I don’t want to know about.

What the story (below) did was to try to present a cute little graphic summary of observational studies that show a statistical association between increasing coffee consumption and fewer early deaths, fewer deaths from heart attack, fewer cases of dementia, and fewer cases of type 2 diabetes.

But such observational studies (they actually never cite the source — I’m just giving them the benefit of the doubt that they’re citing observational studies) CAN’T establish cause and effect, therefore it’s inaccurate for the story to use terms like “cure,” “protective,” and “lowers (or reduces or slashes) your risk.” Besides being inaccurate, such stories fail to educate readers. They mislead.

We ask the editors of Prevention to read and understand our guide “Does the Language Fit the Evidence? Association versus Causation.

Prevention coffee cures.jpg

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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