We can teach children to smell bullshit. How much are readers misled by headlines that imply correlational findings are causal? – Research Digest. By Alex Fradera What do you take from this hypothetical headline: “Reading the Research Digest blog is associated with higher intelligence”?
How about this one: “Reading this blog might increase your intelligence”? According to science writing guides like HealthNewsReview.org, taking the first correlational finding from a peer-reviewed article and reporting it for the public using the second wording, implying causation, is a sin of exaggeration, making a relationship appear more causal than the evidence suggests. Yet this happens a lot. A 2014 British Medical Journal (BMJ) article showed these exaggerations to be rife in media coverage of correlational studies, with 81 per cent of news articles committing the sin. However, the authors of that BMJ analysis started to ponder whether readers interpret these headlines literally, or whether they draw their own conclusions. —How readers understand causal and correlational expressions used in news headlines Related. 152: A MEASURE FOR ESTIMATING THE MAGNITUDE OF UNNECESSARY OVERTREATMENT, OVER TESTING AND OVER PREVENTING.
There is not any summary measure in EBM for showing the magnitude of unnecessary medical interventions including overtreatment, over testing and over preventing.
Based on the finding of a valid and reliable double blinded randomized controlled clinical trial (RCT) with a good external validity, two groups of patients may receive unnecessary overtreatment: the first group consists of patients who will not respond to medication or surgery. The second group consists of patients who respond to the placebo or sham surgery. Here we define an index to cover these two groups: Unnecessary Overtreatment Index (UOI). Paul Glasziou and Iain Chalmers: Ill informed replications will increase our avoidable waste of research – The BMJ. How does the replicability crisis relate to the estimated 85% waste in medical research?
How does the “replicability crisis” relate to the estimated 85% waste in biomedical research? While both issues have gathered considerable attention, they are usually written about separately, as if they are separate problems. They are not: replicability and research waste are intimately intertwined. Poor research design and poor reporting confound attempts at replication, and non-publication can hide “negative” studies that contradict “positive” published studies. Replication in healthcare research is already common. Reporting the findings: Absolute vs relative risk. Why you should always use absolute risk numbers: “New drug cuts heart attack risk in half.”
Sounds like a great drug, huh? Yet it sounds significantly less great when you realize we’re actually talking about a 2% risk dropping to a 1% risk. The risk halved, but in a far less impressive fashion. That’s why absolute numbers matter: They provide readers with enough information to determine the true size of the benefit. Risk is a common health news topic. Testing the usefulness of the number needed to treat to be harmed (NNTH) in benefit-risk evaluations: case study with medicines withdrawn from the European market due to safety reasons. You are using an outdated version of Firefox which is not supported by ResearchGate anymore.
This is not a comprehensive glossary but it outlines some of the key terms that should be understood in relation to Evidence-Based practice. Ultimate Critical Thinking Cheat Sheet. Reassurance After Diagnostic Testing With a Low Pretest Probability of Serious DiseaseSystematic Review and Meta-analysis. Importance Diagnostic tests are often ordered by physicians in patients with a low pretest probability of disease to rule out conditions and reassure the patient.
Objective To study the effect of diagnostic tests on worry about illness, anxiety, symptom persistence, and subsequent use of health care resources in patients with a low pretest probability of serious illness. Evidence Acquisition Systematic review and meta-analysis. We searched MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, PsychINFO, CINAHL, and ProQuest Dissertations electronic databases through December 31, 2011, for eligible randomized controlled trials. The effectiveness of interventions to change six health behaviours: a review of reviews. We identified 103 systematic reviews evaluating interventions aimed at changing health behaviour in one or more of the six areas.
Some of these reviews covered several behaviours. The reviews included studies which targeted specific individuals or organisations (e.g. through counselling within education) or more generally (e.g. mass media interventions or legislation). 1. Evidence for the effectiveness of interventions to prevent, reduce or promote each of the six health behaviours. Let's not confuse measurable with meaningful in primary care. Picture two relatively healthy female patients, both in their 50s.
Neither “Mrs. Smith” nor “Mrs. Johnson” has a family history of breast cancer or any other significant risk factor for this disease. Each woman has been a patient at the same family practice and, over time, each has established a positive, trusting relationship with their doctor, whom we’ll call “Dr. Heterogeneity of treatment effects: from “How to treat” to “Whom to treat” Medical Reversal: Why We Must Raise the Bar Before Adopting New Technologies.
Our world is awash in bullshit health claims. These scientists want to train kids to spot them. Does quality improvement improve quality? Introduction The quality and safety of healthcare worldwide remain problematic.
Many of the basic operational systems and routines of work required to care for patients are not fit for purpose. Effectiveness and Implications of Alternative Placebo Treatments: A Systematic Review and Network Meta-Analysis of Osteoarthritis TrialsEffectiveness and Implications of Alternative Placebo Treatments. From Tufts Medical Center, Sackler School of Graduate Biomedical Sciences of Tufts University, Boston, Massachusetts, and Brown University School of Public Health, Providence, Rhode Island.
Grant Support: By the Agency for Healthcare Research and Quality. Disclosures: Dr. Bannuru reports grants from the Agency for Healthcare Research and Quality during the conduct of the study and grants and personal fees from the American College of Rheumatology and Sanofi outside the submitted work. Dr. McAlindon reports grants from Croma, Flexion Therapeutics, the National Institutes of Health, the Agency for Healthcare Research and Quality, Fidia, Sanofi-Aventis, Samumed, and AbbVie and personal fees from Novartis, McNeil, Bioventus, and the Federal Trade Commission outside the submitted work. Getting clearer on overdiagnosis - Rogers - 2016 - Journal of Evaluation in Clinical Practice.
Overdiagnosis refers to diagnosis that does not benefit patients because the diagnosed condition is not a harmful disease in those individuals. Overdiagnosis has been identified as a problem in cancer screening, diseases such as chronic kidney disease and diabetes, and a range of mental illnesses including depression and attention deficit hyperactivity disorder. In this paper, we describe overdiagnosis, investigate reasons why it occurs, and propose two different types. Misclassification overdiagnosis arises because the diagnostic threshold for the disease in question has been set at a level where many people without harmful disease are nonetheless diagnosed.
We illustrate misclassification overdiagnosis using the example of chronic kidney disease. Misclassification occurs in diseases diagnosed using biomarkers or based on patient reported phenomena. At What Time is a Reduction of Medical Under- or Overtreatment Sensible? Treatment of Acute Depression as an Example. A method for the detailed assessment of medical technologies - RAND. Five year survival rates can mislead. Gerd Gigerenzer, director, Centre for Adaptive Behaviour and Cognition, Max Planck Institute for Human Development, Berlin, Odette Wegwarth, senior research scientist, Harding Centre for Risk Literacy and Centre for Adaptive Behaviour and Cognition, Max Planck Institute for Human Developmentgigerenzer@mpib-berlin.mpg.de Medical trainers and journals need to help get the message across While running for president of the United States the former New York mayor Rudy Giuliani announced in a 2007 campaign advertisement, “I had prostate cancer, 5, 6 years ago.
My chance of surviving prostate cancer—and thank God, I was cured of it—in the United States? Eighty-two percent. My chance of surviving prostate cancer in England? The Lake Wobegon Effect: Why Most Patients Are at Below-Average RiskThe Lake Wobegon Effect. From Memorial Sloan Kettering Cancer Center, New York, New York, and Tufts Medical Center, Boston, Massachusetts. How to prove that your therapy is effective, even when it is not: a guideline.
Why Do We Give Medical Treatment That Increases Patients' Chances of Dying? Why reporting on health and science is a good way to lose friends and alienate people. I was recently invited by Yale Law School's Global Health Justice Program to talk about medicine and the media. I wanted to share the text here. EBM’s Six Dangerous Words. John Ioannidis has dedicated his life to quantifying how science is broken. Rethinking our Thinking about Diagnostic tests: There is nothing Positive or Negative about a Test result. By ROBERT McNUTT, MD & NORTIN M HADLER, MD Making a diagnosis is easy if the test we use to make the diagnosis defines the disease. These sorts of tests, called “reference-standard” tests, when present at any level of the test’s result, make the diagnosis. When Medicine Reverses Itself.
How to Measure a Medical Treatment’s Potential for Harm. Photo. » Mind Your “p”s, RRs, and NNTs: On Good Statistics Behavior. Can This Treatment Help Me? There’s a Statistic for That. Continue reading the main story. The one chart you need to understand any health study. Today, the prestigious academic journal JAMA Internal Medicine published an article on the association between eating whole grains and having a lower risk of death from cardiovascular disease. Many news sources are going to have headlines like "Whole grains lead to heart-healthy benefits" and "Whole Grain Consumption Lowers Death Risk. " Richard Smith: How to fill the void of evidence for everyday practice? NNT - Informacion farmacoterapeutica. Benchmarking Overuse of Medical Interventions for Bronchiolitis. Diagnoses, Predictive Values, and Whether You're Sick or Not: NPV and PPV. A critical interpretive synthesis of recommendations for De-intensification and de-IMPLEmentation from population Screening (DIMPLES).