by Tony Cusano | Mar 16, 2019 | Public
A recent new “study” of the risk in eating eggs is circulating widely in the news and social media.
It provides an excellent example to use for learning how to critically analyze the quality of “scientific” studies reported in the media. This one provides only an observation so weak that it tells us no more about the safety of eating eggs than the observation of a sprinter does about the seeming flat shape of the earth.
Good science measures phenomena under conditions that eliminate as many variables as possible so that the results reflect only the effect of the one being observed. If a test (study) does not do that, it’s bad science. And a famous physicist I know once said to me, “bad science isn’t even science”.
While I could argue at length about the weakness of the statistical results in this case, one need only look at the methods of the study to know that the study was not even science.
First, the authors used inaccurate measurements of egg consumption; a survey that asks people what they ate. Surveys for diet recall are inaccurate because of memory fallibility, as well as emotional overlays that skew answers given. Plus, it only measured egg consumption in one set of surveys at the beginning of the study, and never checked again over the ensuing 17.5 years to measure any changes in the answers. Do you think eating habits never change?
Second, although the authors tried to use statistical methods to account for variables that might have been affected the subjects, like weight, blood pressure, or diabetes, they did not eliminate or even account for many important variables that could have been linked to egg consumption, such as other unhealthy behaviors like high salt consumption or lack of exercise.
Think of it this way; a good way to eliminate variables is to take the thousands of people and divide them randomly into 2 groups. That would make each group likely to have the same distribution of important unmeasured variables, thus eliminating those variables from having any different effect in one group or the other. This study did not do that.
(And even in studies that do try to randomize out variables, the more possible variables, the larger the number of subjects that are needed to assure they are distributed evenly in both groups.)
The problems limiting this study are similar to the ones that lead us to discount a sprinter’s observations about the shape of the earth. First, the sprinter is only measuring the ground with her feet, not a carefully calibrated 3 dimensional ruler. Second, if the sprinter kept going in a straight line long enough she would return to the start from the opposite side, leading to the correct conclusion that the world could not be flat, as it appeared to be over the first few hundred yards. Her observations were too limited to be useful as science.
This study did not randomly divide the participants, it divided them based on egg consumption. Nothing they measured after that can be considered factually valid because the groups were not truly equal in the distribution of other unmeasured variables. But even if they did randomize, they would need hundreds of thousands of subjects to have measured enough to “randomize out” the large number of unmeasured variables. And they would have needed to measure the important variable, egg consumption, more rigorously over time.
Don’t be fooled by catchy headlines based on the conclusions of scientists trying to inflate the importance of their work. If the work was bad science, it wasn’t even science, and they weren’t acting as scientists. The media needs them to look smart so they can sell their news. You don’t need to listen.
If you want more guidance on how to critically analyze scientific reports in the news, we can help coach you on effective practices.
Call or email us for a free consultation.
by Tony Cusano | Mar 4, 2019 | Public
Many people are aware of the controversy over the use of statins for preventing cardiovascular events in patients at high risk but who have not had any previous known heart disease.
This clear and thorough presentation of the controversy illustrates both its complexity, and why it is critical that you and your doctor make a collaborative shared decision before using statins to reduce your cholesterol as a way to prevent cardiovascular disease.
The benefit of statins is unclear compared to their risks. In this setting of medical uncertainty, it is critical that your own values and goals guide the decision on whether to take them or not.
It is important to recall that there are alternatives to taking statins like exercise and diet for preventing cardiovascular disease, and although they are difficult to execute, they likely carry less risk.
Some may prefer to take their chances with medications that clearly have some benefit, but others may prefer to make stronger efforts at lifestyle changes.
A collaborative decision with your doctor allows you to make the choice that you prefer, rather than the one that experts who don’t know you have promoted.
If you were not sure about how to collaborate in this way with your doctor, we can help. Email or call for a free consultation regarding our education, coaching, and advocacy.
by Tony Cusano | Feb 17, 2019 | Public
The culture of medicine has blinded many doctors to the substantial risks of taking the powerful fluoroquinolone antibiotics. They are effective, generally well tolerated, and appear quite safe.
But the FDA has ramped up its warnings to avoid using them when alternatives are available. Unfortunately, many of those have their own risks and tolerability issues. Doctors like the simplicity that using Fluoroquinolone antibiotics provides.
The only way to be sure you or a loved one is taking the best medication for a routine, or even a complex infection is to collaborate with your doctor to make a shared decision that accounts for all of the benefits, risks, alternatives and unknowns. It seems like a lot for a sinus infection, but as the article shows, it’s critical to assure that your doctor has listened to and considered your individual values and goals.
If you’re not sure if or how to ask, we can coach, educate and advocate.
Call or email for a free initial consultation.
by Tony Cusano | Feb 13, 2019 | Public
LASIK eye surgery is very popular and when it works as intended, very helpful. However, a a recent controversy raised by one of the original FDA group who studied and approved the procedure reveals the need to apply a rigorous analysis of the benefits, risks, alternatives and unknowns of undergoing the procedure yourself.
One claim for a low serious complication rate of 1/1000 is 0.1 %, and when that is applied to the 10 million procedures per year, it adds up to 1000 people per year who are harmed by the procedure.
That averages out to 20 people people each week.
That’s not to say it’s not worth doing it, but a rigorous judgement of whether the small risk is truly worth the benefit is important to avoid devastating regrets.
If you feel uncomfortable about how to share the decision fully with your doctor, contact us for a free consultation.
by Tony Cusano | Jan 21, 2019 | Public
The last place in medicine we expect any new discoveries is in anatomy. But in the last year there have been two stunners. Scientists found an invisible network of channels that course through our bodies opening all sorts of possibilities for how our cells communicate and function, and how medications circulate.
And recently scientists have discovered similarly invisible channels in solid bone, again opening up huge gaps in our understanding of the blood and immune system, of bone itself, and of how we handle medications.
These discoveries remind us of the importance of a thorough understanding of the benefits, risks, alternatives and unknowns involved in any medical decision, and of collaborating with doctor to share such decisions so they follow your own values and goals.
We can educate, coach and advocate to help with your collaboration.
Email or call for a free initial consultation.
Recent Comments