Get your health news here

Source: NHS Brand Guidelines

As promised in the last post, I have a recommendation for a source of health news. It’s a site called Behind the Headlines. It comes from the National Health Service (NHS), the publicly funded health care system of the United Kingdom, and it’s available on the Internet at Behind the Headlines.
The information in Behind the Headlines articles comes from Bazian, a company that provides evidence-based information to publications and healthcare systems. I won’t go into all the pros and cons of evidence-based medicine (EBM) in this post. Just a brief overview, and why it’s useful in analyzing the news. (EBM has a poor reputation in the US because some insurance companies have used it to deny benefits to patients.)

Evidence-based medicine

Keeping up with the latest research.

Source: JAMA

EBM was introduced to the American medical community in 1992. Its first fundamental principle is called hierarchy of evidence, which says that some forms of medical evidence are better than others. In particular, randomized clinical trials (where participants are assigned to treatment and control groups by chance) are considered much more valuable than

• observational studies (trials that are not randomized)
• case reports (detailed information on individual patients)
• the experience and intuition of physicians
• the underlying biology and physiology of a disease

.
If you follow health news, you know that individuals, MDs, and those who create health policy cannot rely on the results of the latest clinical trial. A new trial next month might reach a very different conclusion. EBM uses a concept from statistics called meta-analysis, where the data from many clinical trials are combined and analyzed.

Problems with clinical trials

Of course the results of meta-analysis are only as good as the studies you choose to include and exclude. There has been an enormous increase in the funding of clinical trials by drug companies and other for-profit groups. It is estimated that more than half of medical research studies are funded by an entity that has an interest in the outcome. A study of major cardiovascular clinical trials found that trials funded by for-profit groups are more likely to report positive findings, favorable to the sponsor, than similar trials funded by nonprofit groups. On the exclusion side, more than half of clinical trials on the safety of new drugs are never published in scientific journals. So even in a meta-analysis, statistics can be manipulated, and results are open to interpretation.

Most health news stories that sport an alarming headline (“Cell Phones Cause Cancer”) are based either on articles that appear in major medical publications, announcements made at a press conference, or research described in press releases. All these in turn are based on the results of clinical trials of one sort or another. What I like about Behind the Headlines is that the stories include details about the type of clinical trial and the evidence that generated the story. There is an explanation of why you might reasonably choose to ignore the results given the small sample size, evidence of bias, or the unreliability of the type of trial.
For example, some evidence is based on people filling out a questionnaire that asks what they have eaten during the past year. Such surveys are known to produce notoriously poor data. Not only is memory unreliable, but it’s easy to overestimate our consumption of what we all know by now is a healthy diet. Some studies draw conclusions by comparing people who live in different countries (epidemiology studies). Most people who live in Mediterranean countries eat (by definition) a Mediterranean diet. They may be healthier, and they may live longer. But is that due to what they eat or to stronger social ties that contribute to good health? The Behind the Headlines articles always note any obvious limitations of the scientific study in question and conclude with information that allows you to draw your own conclusion.

Health news posts coming soon

Most health news has international implications, so analysis from a UK perspective is still relevant to those of us in the US. I will plan to keep you posted on the latest stories covered by Behind the Headlines. And I’ll also look at some articles from their archives, beginning with a subject close to my heart: the health benefits of chocolate.