Trials and public reporting

Heart healthy behavior
May 15, 2011
The doctor is SICK
June 16, 2011

Hi everyone, haven’t posted for a while and wanted to get back out there.  I hope you all are doing well.

I thought I would write a quick note and see how many of you pay attention to medical news.  Typical articles summarize new trials or research findings.  A new one making the rounds in my medical circles involves a trial looking at the use of niacin in patients already on statins, AIM-HIGH, was halted early because the trial did not show any benefit for the use of niacin in these patients.  It is interesting to me because niacin was one of the first drugs for cholesterol to show any benefit in not only lowering cholesterol but also reducing cardiovascular events (heart attacks and strokes).  The full implications are still being discussed but this will likely impact those patients and probably less use of the drug.  I am curious if any of you on the interwebs heard of it?  My guess is no since niacin is not first-line therapy for cholesterol and the trial was negative.

My own observations of medical reporting is that it seems very hit or miss.  The news websites, TV and newspapers only report the most sensational new discoveries or potential side effects.  I recognize of course they need to compete for the reader’s attention.  I also think they oversimplify quite frequently, although I would certainly acknowledge it is probably difficult to summarize some content for a non-technical audience.  The main thing I have a problem with is how they package the message from many observational trials.  These trials are not done to prove cause and effect, but rather to generate hypotheses for further investigations.  One example is of a recent CORRELATION that showed up between calcium supplementation and heart disease.  The two were more frequent in a group of patients who had heart disease compared to a group that didn’t.  That’s it, this does not in any way prove the calcium supplements (taken by millions of patients with osteoporosis) CAUSE heart disease.  Yet the take home message many patients get is exactly the latter, leading to a lot of anxiety on their part (it takes some time to reassure them, let me tell you) and potentially needless avoidance of a potentially helpful medication.  There have been numerous other reports causing the same confusion.

I think the news media need to do a much better job explaining how this is only poor-quality data and further studies are needed to establish whether one causes the other.  Or better yet, not to report this to the public at all, since these data are very inconclusive, and reporting it, I think, leads to more harm than good.

What do you think?  Do you pay much attention to these reports?  Does the public have a “right to know” even when knowing is potentially harmful and confusing?  Do you see a lot of these articles and have you been misled?  As always I welcome your comments!

1 Comment

  1. Anonymous says:

    You are the doctor so I trust you to make the right call. You came into this profession to help people so I am sure you would never consciously put your patients at undue risk

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