March 14th, 2011 by GarySchwitzer in News, Research
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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*
March 8th, 2011 by AnnMacDonald in Health Tips, Research
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Teenagers and young adults who use marijuana may be messing with their heads in ways they don’t intend.
Evidence is mounting that regular marijuana use increases the chance that a teenager will develop psychosis, a pattern of unusual thoughts or perceptions, such as believing the television is transmitting secret messages. It also increases the risk of developing schizophrenia, a disabling brain disorder that not only causes psychosis, but also problems concentrating and loss of emotional expression.
In one recent study that followed nearly 2,000 teenagers as they became young adults, young people who smoked marijuana at least five times were twice as likely to have developed psychosis over the next 10 years as those who didn’t smoke pot.
Another new paper concluded that early marijuana use could actually hasten the onset of psychosis by three years. Those most at risk are youths who already have a mother, father, or sibling with schizophrenia or some other psychotic disorder.
Young people with a parent or sibling affected by psychosis have a roughly one in 10 chance of developing the condition themselves — even if they never smoke pot. Regular marijuana use, however, doubles their risk — to a one in five chance of becoming psychotic.
In comparison, youths in families unaffected by psychosis have a seven in 1,000 chance of developing it. If they smoke pot regularly, the risk doubles to 14 in 1,000. Read more »
*This blog post was originally published at Harvard Health Blog*
March 8th, 2011 by GarySchwitzer in News, Opinion, Research
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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 FoxNews.com 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 CBSNews.com 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*
September 3rd, 2010 by GarySchwitzer in Better Health Network, Health Policy, Health Tips, News, Opinion, Quackery Exposed, Research
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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.”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
June 27th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research, True Stories
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People aren’t dumb. Even if — or maybe especially if — news stories don’t point out the limitations of observational studies and the fact that they can’t establish cause-and-effect, many readers seem to get it.
Here are some of the online user comments in response to a CNN.com story that is headlined, “Coffee may cut risk for some cancers“:
* “I love how an article starts with something positive and then slowly becomes a little gloomy. So is it good or not? I’m still where I was with coffee, it’s all in moderation, it ain’t gonna solve your health woes.”
* “The statistics book in a class I’m taking uses coffee as an example of statistics run amuck. It seems coffee has caused all the cancers and cures them at the same time.” Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
