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The “Lies” Of Medical Science: What’s An e-Patient To Do?

There’s an extraordinary new article in The Atlantic entitled “Lies, Damned Lies, and Medical Science.” It echos an excellent article in our Journal of Participatory Medicine (JoPM) a year ago by Richard W. Smith, 25-year editor of the British Medical Journal, entitled “In Search Of an Optimal Peer Review System.

JoPM, Oct 21, 2009: “….most of what appears in peer-reviewed journals is scientifically weak.”

The Atlantic, Oct. 16, 2010: “Much of what medical researchers conclude in their studies is misleading, exaggerated, or flat-out wrong.”

JoPM 2009: “Yet peer review remains sacred, worshiped by scientists and central to the processes of science — awarding grants, publishing, and dishing out prizes.”

The Atlantic 2010: “So why are doctors — to a striking extent — still drawing upon misinformation in their everyday practice?”

Dr. Marcia Angell said something just as damning in December 2008 in the New York Review of Books: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” (Our post on Angell is here.)

What’s an e-patient to do? How are patients supposed to research if, as all three authorities say, much of what they read is scientifically weak? Read more »

*This blog post was originally published at e-Patients.net*

The Health Hive: Is It Ready For Primetime?

Maybe not according to this report from the CDC. They studied Internet use with respect to adherence behavior and a number of health-related outcomes. It suggests that folks who diss the doc in favor of the Internet may not do as well as we think.

This quote caught me:

The data also revealed that personal determinants such as neuroticism (reflects anxiety and emotionality) and health-related poorer quality of life differentiated internet-instigated non-adherent respondents from their counterparts.

More plainly put: If you trust your life to an anonymous guy on Twitter with the handle @YourHealthGuru, you might not do as well as if you partnered with a trained professional. Or perhaps I’m reading too much into the study. Read more »

*This blog post was originally published at 33 Charts*

The Mayo Clinic Center For Social Media: What It Represents

In a move that may represent a new level of social health organization within large institutions, the Mayo Clinic announced that it has launched The Mayo Clinic Center for Social Media. Mayo intends to “accelerate effective application of social media tools throughout Mayo Clinic and to spur broader and deeper engagement in social media by hospitals, medical professionals and patients to improve health globally.”

Look for more information in Mayo’s press release which is diplomatically vague while at the same time lofty and enticing.

So what does this really mean?

The Mayo Clinic recognizes opportunity. The opportunity to formally offer comprehensive social media training to hospitals and medical schools is huge. The Mayo Clinic can and should leverage what they’ve done both to their own advantage and to help create a new standard for providers. While the details are forthcoming, Mayo Clinic’s manager of social and sydicated media Lee Aase tells us that Mayo wants to make available its resources, training, toolkits and legal guidelines to fledgling hospitals. Read more »

*This blog post was originally published at 33 Charts*

Evidence-Based Medicine: Do Patients Understand It?

Doctors trying to help patients understand a course of treatment must teach them new terms such as “medical evidence,” “quality guidelines” and “quality standards.” Patients might not be willing to accept that language lesson.

A study in Health Affairs concluded that 41 percent of patients didn’t ask questions or tell doctors about problems. The main barriers were that patients didn’t know how to talk to doctors, or their physicians seemed rushed. Only 34 percent of patients recalled physicians discussing medical research in relation to care management.

But, physicians say, that’s only half the problem. Sometimes, patients demand to see specialists when they don’t really need to. Or, they don’t accept it when evidence shows that highly-desired treatments aren’t the best ones for care. One reason may be that one in three patients believe that more expensive treatments work better than less expensive ones, according to the study in Health Affairs. Once the evidence is laid out, it can be a delicate negotiation to get patients to accept that. (American Medical News, Health Affairs, RangelMD, KevinMD)

*This blog post was originally published at ACP Internist*

Herbal Remedy For UTI? If You’re A Lab Rat, Maybe

Lab ratA patient came into the office the other day carrying a small clipping from a reputable women’s health newsletter touting new research on an herbal remedy for urinary tract infection. Having recurrent bladder infections, my patient naturally was wondering if this was something she should try.

The article was entitled “Herbal Remedy Effective for Urinary Tract Infections” and began with this startling revelation:

The common herbal extract forskolin can greatly reduce urinary tract infections and could potentially help antibiotics kill the bacteria that cause most bladder infections. 

But the article advised that the “popular” remedy was not FDA approved for this indication, so you should “ask your doctor.” Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

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