Imagine you woke up today, and I told you, over the next week read all the available health information that is published and tell me what we should invest in and equally what we should disinvest in: what choices should you make, on an individual basis and at the public health level to maximise your health and others.

My thoughts are this is now such a complex question it may be impossible to answer. One reason for this is the exponential growth of health care information on the worldwide web. Google search for health currently generates 844,000,000 pages.

In the US, 80% of internet users, 113 million adults, have searched for information on at least one of seventeen health topics. Yet, just 15% of health seekers say they “always” check the source and date of the health information they find online, whilst 3/4 say they check the source and date “only sometimes,” “hardly ever,” or “never,” which translates to about 85 million Americans gathering health advice online without asking whether the information is based on credible sources.

Now, imagine if I made it even more complicated, by telling you over the next year you have to come up with a credible plan for rational disinvestment in health care. Now you’re in trouble, for instance the number of randomized trials has gone from 39 RCTs in 1965 to 26,017 in 2008. At current rates we can expect to see 50,000 RCTs per year published by 2018-9.

Now you’ve managed to wade through all this health information and find the articles you need, you are faced with research which is not always transparent. For instance, the so-called “Sunshine Act”, is currently going through the US legislature, aiming to completely overhaul the interactions between physicians and the pharmaceutical industry. Yet, Fiona Godlee tells us in her editorial today that ‘articles that gave a favourable view on the risks were significantly more likely to have authors with financial ties to the manufacturers’. Even if you can locate the evidence that makes a difference, you are often left wondering can you believe it.

You’ve located the studies you’ve got beyond the vested interests and maybe feeling slightly smug but now you have to intepret the statistics. Do people understand statistics, do they trust statistics?

Most of the concepts are foreign to most individuals, even those with advanced degrees and most of us get through education, including university, without ever taking any kind of class in stats. Many surveys show heaps of people lack basic numerical skills that are essential to maintain health and make informed medical decisions. Yet, low numeracy distorts perceptions of risks and benefits of screening, reduces medication compliance, impedes access to treatments, impairs risk communication, limiting prevention efforts among the most vulnerable.

Based on what I have said do you feel equipped to understand the major evidence in healthcare? Well, I haven’t even mentioned the ten major biases that lead to mis-information and the role the media has in all this in relaying the final message. I’ll leave the last of these to the excellent Bad Science

Let me know, is there anyone out there who can understand Evidence in Health Care Anymore?

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