When it comes to research, read between the lines
There is no question that research is truly the foundation of many advances in health care. Most health professions, including chiropractic, boast a significant amount of data, clinical studies and double blind trials- everything from chronic pain to return to work rates. With the amount of information available, it begs the question, is all research created equal? The short answer is no.
We have the media to thank for the sensational headlines that grab our attention. From week to week we hear about studies that suggest wine is bad for you, only to hear a contradictory story the following week that indicates wine can prevent certain diseases. There are also huge breakthroughs in science that are touted as stepping stones in the battle against arthritis, aging and disease, yet we’re not getting any younger and our health care treatments are still much the same. Even more telling, many cases in health care have already taken place where a “wonder drug” or treatment comes onto the market, only to have catastrophic consequences and adverse effects. How do we know what to believe? With a little investigation, it is easy to pick up on some of the clues.
1. The title of the research. Often the media headline has nothing to do with the actual study itself. The title of the research is your first clue into what is being investigated and could suggest the potential outcome. The title should also give you a hint as to who may be (or should be) conducting the research.
2. Who is conducting the research? It makes sense that a medical doctor would publish research on cancer but is a dentist qualified to conduct research into spinal stenosis? Usually you won’t see this kind of extreme (eg. dentist studying the spine) but you will notice more subtle concerns. Is it fair to say that health care providers who specialize in a certain treatment or specific anatomy as their core competency will deliver a better result than professionals whose education covers only the very basics of this skill set? Chances are, those with the least experience will achieve a less favourable outcome.
3. What kind of a study is it? There are many different types of published research. When it comes to health care, the two main types are systematic reviews and clinical trials/experiment based research. Generally, more credibility can be given to the clinical trials as the knowledge is gained first hand. Systematic reviews can be helpful too, but it is important to review the references section to ensure credible, recent sources are used. Watch for systematic reviews that reference many other systematic reviews, simply republishing the same details over and over. The selection criteria in a systematic review are also very important. If there are 2,000 available articles for the review, why were only 10 used for the publication?
4. Check out the research references. All quality research papers will list references. Review these lists and look for the age of the data – is it recent, or are we rehashing an old, defeated study? You can also investigate the title and principal researchers of the references to ensure that the correct people are studying appropriate topics.
5. Research is biased. We are all human and therefore bias exists in research. Many researchers do a great job of maintaining as neutral a stance as possible, however, it is easy to “flavour” the research thanks to our personal experiences. Statistics are easily manipulated to achieve the effect we want. Especially in the case of systematic reviews, it is not difficult to add study requirements that eliminate publications which highlight the opposite of the desired outcome.
6. Most importantly… Does the research ring true to you? It is very easy for us to accept research that suggests obesity is bad for your heart, but what if you see a study that suggests that a treatment you find beneficial has no merit at all? As a patient who has found relief, how does this make you feel? Your own experience in the health care system should play a role in how you interpret health research. Each patient is an individual and as a health care consumer, you are allowed to be biased and make choices that work best for you.
The goal of all health care research should always be the same goal as that of each individual health care provider – to improve the health of the patient. Sometimes, this message can be lost and distorts the outcome of published work. With the right questions and a little research into “the research,” sorting the fact from fiction can provide greater insight when it comes time to make health care decisions.