Everyone has an interest in exaggeration
Think about health care communication to the public. Is it done well, does it lead to informed choice? Do you feel skeptical about the issue, and disillusioned with the current status of communication of health to a wider audience.
Today, at Kellogg College, at the University of Oxford a workshop on ‘Enhancing the Public Understanding of Health Research’ aimed to bring together folk with experience in developing and evaluating materials to help people become better users of health research. The question is, why isn’t the public informed? The two issues when we are faced with research findings, whether it be on TV, in the newspapers or in a scientific journal, are ‘Why should I believe these results,” and “What do they mean?”
Steve Woolshin and Lisa Schwarz authors of the ‘Know Your Chances’ book, talked enthusiastically, and with an array of examples, of the bigger picture and what is out there.
The issue that caught my eye was how invested we all are in exaggeration: manufacturers to sell products, academics to get their research published, journals to get their research cited and picked up by the news and for media to gain more advertising revenue. And so the cycle goes on.
For instance, Dannon's Activia, exaggerated health claims led to a US $21M fine, a further example is a study which suggests, ‘nutrient enhanced water drinks are ''''expensive lolly waters'''' with exaggerated health claims’. All sorts of exaggerations occur on a daily basis ‘Radiation health fears exaggerated, claims Oxford professor’. Just try googling ‘exaggerated health claims’.
My favourite is vitamin D which has reached rock-star status in recent years, as a potential cure for the prevention of everything.
The BBC even highlights medical journals are all part of the exaggeration phenomena: ‘Medical journals have been accused of hyping up the findings of the research that they publish.’
Am I prone to exaggeration, you bet I am! Obviously this is the best site worldwide to find the opinion on the evidence to trust.
Improving trial publications: where do we start?
There has been considerable interest in the transparent publication of trial results in both the media and the big journals. Whilst calls for drug companies to be more open with research findings are on the increase.
‘that patients should demand as a condition of their participation in trials that their anonymised data should be made available to anyone who asks for them and that ethics committees should back them up, insisting that protocols allow for data sharing.'
Half of trials supporting FDA applications go unpublished 5 years after approval. A further example of the controversy in action, is the recent Cochrane review on Tamiflu in adults, which Fiona Godlee, editor of the BMJ questions ‘Why don’t we have all the evidence on oseltamivir?’
But, the problem is once we have all this data who is going to look at it? Even one trial alone is going to take a year’s work. Who is independent enough to do this work and who will fund it? There are only a few epidemiologists in the world barmy enough to do this sort of work. I should know I’m one of them.
A recent systematic review published in BMC trials of pharmacological interventions for acute ischaemic stroke that were completed, revealed of 940 trials 125 (20%) were completed but not published in full. Gibson who led the work states: ‘Responsibility for non-publication lies with investigators, but pharmaceutical companies, research ethics committees, journals and governments can all encourage the timely publication of trial data. ‘
Therefore the question right now is not ‘let us have the raw data’ but, ‘let’s get the stuff published in the first place.' My standpoint would be to have a two year maximum to publication from the end of the trial outcome assessment. Otherwise trial registration should be removed from which ever organisation registered the trial in the first place.
Only simple solutions will make a differnce and its where we should start.