This is what the page of the local newspaper & health welfare should be?

I get excited when I see a newspaper – as my local Star Tribune-add a science page, which they did recently.  And I don't get too upset that none of the entries on this page of science were produced locally. Better than nothing, I thought.  No damage.  Maybe it will improve science literacy and interest in science, a little on some readers.

Then Sunday Star Tribune yesterday splashes this health + wellbeing page on me.  And 80% of the page is dedicated to a story lifted from the book of Hackensack, NJ, the registry.   Nothing against Hackensack or the registry.  But this story was about heart artery catheterization done through pulse – "a European doctors approach have used for years."

Interesting.

And now it is being done in New Jersey.  And the story ends with a NJ NJ doc predicting: "I think, eventually, 90 percent of patients will be able to have it".

But I don't live in New Jersey.  I live in Minnesota.  And the Star Tribune is a part of Minnesota.

And THERE Is Not A Word HERE ABOUT WHETHER SOMEONE Is DOING THIS In MINNESOTA1

This is what we call shovelware.  Nothing in the shovel to create the appearance of a health/medicine specialized page .... Heck, even call it a page of "wellness", because what's hot.

As a new sign that an entity orphaned this page little excuse of not-so-special was, was the variety section (!), hidden among the characteristics the GIRL POWER! .... making us laugh in MINNESOTA ... something called the junk drawer ... and a review of the film "The Dark Knight Rises".

Now, that's where I think it look for a health/well-being page, with a story about interventional cardiology!

 

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Pill of progress: what are the chances of a drug becomes for the market?

The following is a guest post by Chad Parmet, a research associate with the Foundation for informed medical decisions.  Chad meets, assesses and summarizes the current medical research to support decision-making programs shared ® new or revised. Prior to joining the Foundation, he worked as a medical writer. He holds a Bachelor's degree in physics from the University of Pennsylvania. In the past, he revised many stories to HealthNewsReview.org. (Foundation is funding this project, but has no control over what is published here).

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Many times I read that researchers have cooked some new wonder drug that will change the world. But many of these miracles never materialised. That is why one of the criteria HealthNewsReview.org rates articles on if they ever set appropriate expectations about the availability of the hot new thing.

But what should be a drug that is still being tested our expectations?

A compound can do it in a prescription, it must run a gauntlet of studies in animals and humans. FDA analyzes the results and decide whether to approve it for use in Americans.

So I've been thinking: what are the chances that a drug in the midst of this challenge, generating headlines along the way, will never make it our medicine cabinets?

I poked around Google, PubMed and trip to evidence about these probabilities. Haven't seen any meta-analyses. I found a series of studies that used different estimates to produce chances. Clearly, I can't make a reliable estimate of the odds without finding a solid, systematic meta-analysis of studies of high quality. That said, the estimates were at the same level. And the stadium was interesting.

The chart below is my "essence" of the results of the recent, reviewed studies that — in my opinion — were more generalizable to small-molecule drugs that seek their first indications of the FDA.

The odds that a drug to each phase of the research
will eventually make it to the market

 

The essence of Adams Bratner & Davis et al 2006, 2011, DiMasi et al 2010, Kola & Landis 2004 and Paul et al 2010

Here are some important caveats about these numbers:

I could go. This is not an academic study, just an exercise.

With these limitations in mind, the true essence of exercise is that I take experimental drugs seem to have a lower likelihood of doing so on the market than what one would expect from the revolutionary tone used in typical news coverage next miracle drug.

I would love to know if there is a formal meta-analysis or a summary of the best literature, that I missed. If you know of one, please leave a comment below.

Chad Parmet

Disclaimer: all searches and conclusions are my own and do not represent the views and opinions of my employer, the basis of informed medical decisions.

 

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Health news Watchdog barks at stories about health of children and dogs

An article published in Pediatrics, Respiratory tract diseases during the first year of life: effect of dog and cat contacts "is getting a lot of attention in the news, but more than misses what most of these stories generally Miss: you cannot prove cause and effect from an observational study.  And there are major limitations on research based on people keeping diaries and answer questionnaires.

The study concludes:

".. dog contacts may have a protective effect on the respiratory tract infections during the first year of life. Our findings support the theory that, during the first year of life, contacts are important, possibly leading to greater resistance to infectious respiratory diseases during childhood "

The Wall Street Journal reported:

"While the study controlled just under 400 babies, the researchers said that the results were statistically significant because it relied on questionnaires completed by parents. weekly" (Our reaction: huh?  This sentence makes no sense.  Statistical significance is not determined by filling out questionnaires from parents.)

WebMD reported:

"It is not clear why live with a dog makes a difference."  (Our reaction: it is not clear that living with a dog makes a difference. Making a difference means you have already proved the cause and effect and this study did not do it.)

HealthDay reported:

"Exhibition of cats also showed a protective effect, but was not as strong as the effect of exposure of the dog". (Our reaction: no protective effect was created in this observational study.)

None of these news organizations earlier and any of the following mentioned the limitations of observational studies and that it is not possible to establish a causal relationship.  Reuters Health nor the Los Angeles Times, or CNN. (90 minutes later Addendum: Nor CBS.  Or TIME.com. Neither the Toronto Star. )

From our early morning sweep, just a news story of my HealthNewsDaily the MSNBC.com included what we were looking for:

"The relationship between pets and less infections held even when the researchers took into account factors known to affect infection rates of infants, how to breastfeed and number of brothers. Still, the researchers acknowledged that it could not account for all factors and noted that they found a correlation, not a relationship of cause and effect. "

That wasn't so hard, was it?

Our usual reminder: journalists and consumers must read our booklet, "the language fits the evidence?  Association Versus causation. "

View the original article here

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Marketing and politicize the menopause

The Associated Press reported this week the marketing of a new product line of menopause – "a line of products that target American women 50 million that are or will soon go through menopause. Prices between $ 9.99 and $ 7.99, the line includes lubricant for vaginal dryness, adhesives, socks and feminine cleaning air freshener to the odor and cooling gel roll-on and wipes for women have hot flashes. " Snippet:

Feminine washes are usually not recommended by many doctors, says Dr. Lauren f. Streicher, a gynecologist and Assistant professor of Obstetrics and Gynecology at Feinberg School of medicine in Chicago. And vaginal odor products that mask can cause people to not treat what is causing this symptom in the first place, she added.

"The idea to cover it with an air freshener is an inadequate approach," said Streicher. "I'm very happy people are paying attention, but I don't want to see people harnessed."

And USA Today reports:

But do we really need more products that suggest that women basically stink? The new "daily freshness" products — like all sprays, Douches and cleanser before them — can actually be harmful, doctors say.

"The vaginal odor is not a common symptom that patients come to physicians," or a problem that becomes more common during menopause, says Elisa Ross, an obstetrician/gynecologist at the Cleveland Clinic. When a woman realizes a unusual odor, she may have an infection, Ross says, "very few doctors recommend these products cleaning because they can mask the symptoms that should be brought to the attention of a doctor. They can also cause irritation if. "

Also this week, Liz Scherer, not your Mama Flashfree: menopause, wrote, "Politicizing menopause."   Read the whole post for yourself.  But I wanted to get two excerpts:

"It is possible that menopause has been Government overpoliticized, medicalizada and poorly characterized, a phenomenon not kidnapped by medicine as gradually occupied, [with] the authorities throughout the ages grimly trying and do not set your subject?" "" We are drowning in politics, medicine and industry. And it is difficult to discern the truth from fiction, the data from the data, the risk of benefit

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Epidemiologists call them "absolute risk"; you and I could call them real numbers

In a recent Huffington Post blog post, Gil Welch Dartmouth approached a old topic, our pet, "the problem is relative."  Snippet:

Numerous studies have shown that the general public has exaggerated perceptions of health risks they face — as well as exaggerated expectations of the provision of medical care.

It is because they are stupid? No instead, the problem concerns how various sources of health information — researchers, doctors, reporters, web designers, advertisers, etc. — often frame their messages: using the relative change.

"Forty percent more high" and "low" are 50% more variation on declarations. While they are easy to understand, they are also incomplete. Relative change drastically can overstate the underlying effect. It's a great way to scare people.

For example, survey earlier this year found that women with migraine had a 40 percent greater chance of developing multiple sclerosis. That looks scary.

But the researchers were careful to add some important context: multiple sclerosis is a rare disease. In fact, for women with migraine, the chance of developing multiple sclerosis over 15 years was considerably less than 100 — 1:0 pm each only 0.47%. To be sure, which is about 40% higher than the analogous to women without migraines — 0.32% — but it's much less scary. More importantly, it is a much more complete piece of information.

What makes it more complete is the context of the two additional numbers: the risk of developing multiple sclerosis in women with and without migraine. Epidemiologists call these risks "absolutes". You and I could call them real numbers.

Relative change also exaggerate the effects in the other direction. It's a great way to make people believe that there was a real breakthrough.

When we HealthNewsReview.org, generally grade stories in give them a poor score for the criteria of "quantification of benefits" or "quantification of damages" if they use only values of relative risk.

 

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The news of alcohol-osteoporosis: only 40 women ... just a surrogate marker

In a race to the incomplete news coverage, news about a study published in the journal menopause, "the moderate alcohol consumption reduces the biochemical markers of bone turnover in postmenopausal women," can overcome the news earlier in the week from a BMJ paper on alcohol and arthritis – both in volume and in the absence of key restrictions.

This was a small study of short term in just 40 women.  Still look as final are the statements in this sampling of headlines:

Nightly glass of wine may protect bones female Boomer

Cocktails can prevent bone loss

Ladies drink for health (bone)

DRINK UP FOR STRONG BONES

Bottoms up, ladies! Moderate drinking can be good for your bones

Drink increases bone health: study

Good news for drinkers! A glass of wine per day ' protects women against the fragile ...

Let's drink to that! Two glasses of wine per day ends the misery of menopause

"Although there is substantial evidence that moderate alcohol consumption correlates with higher density of bone mass in postmenopausal women, is far less clear whether drinking alcohol decreases the rate of fracture," the authors write. "So even if drinking had no detrimental effect, it would be imprudent to recommend drinking with the purpose of preventing fractures."

Previously the story took care to explain:

Researchers followed certain blood markers of bone health throughout and thought these markers of bone density positively correlated with alcohol consumption: in other words, the more the Women drank within moderate range, seemed the best of your bone health.

I added the emphasis in red to stress that – in other words – this study looked at only a surrogate marker.  Should women worry with a marker of blood?  Or should they care about real results as fractures? This study did not show anything about the latter.  That doesn't make it unimportant.  Research is intriguing.  But the news coverage generally do not point this important limitation. Exaggerated stories and exaggerated.

Maybe the journalists were seduced by the comments of researchers: "the results presented here have a clear message to public health, as well as for practicing clinicians Advisory and management of patients at risk of osteoporosis."  It seems a little on the top, given the limitations that we have highlighted.

Journalists and consumers must read our little primer, "surrogate markers may not tell the whole story."  Journalists need to ask themselves: what was the result that is being studied?  What was the endpoint? How many people? For how long?  What to say and what we say about the importance of this?

(Photo credit: Thoursie on stock.xchng)

 

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