How do we know what research/information to believe when we are trying to read into a subject?

[ElleC]

It strikes me reading through the forum topics that there is a lot of confusion over what advice to believe? I thought it would be useful to stimulate a debate into this topic so I will start...

I think what is important when reading into a subject matter is to consider the following:

1) the author of who is righting the article/the video/research paper. Consider what might be theri motivation to write the article? What is their background? For example a completely independent medical professional is likely to have a very different viewpoint to a drugs rep for a pharmaceutical company who is also going to have a very different opinion to a person who perceives they have had a bad reaction to medication they have been given. You must consider are they biased? Which way? Why?

2) The supporting evidence. There are so many different forms of research. As a rule the best form of research is that based on trials of large numbers of people, with controlled groups and placebo groups. What is really important is to ask is there supporting evidence? Be really careful of someone who presents something as fact... ask what evidence they have to back up what they are saying? If they have none question how they feel qualified to ask give such specific advice. There are A LOT of people on the internet who are convincing in their standpoint yet there is absolutely NOTHING to back up what they are saying.

3) Be ware of conspiracy theorists? People who think everything is a cover up. As above, ask what evidence do they have to back up their theories? Or are they just that theories? Has there been any research done? What were the numbers involved in this? Was is a controlled trial? Don't be blinded by medical professionals clouding your judgement, just because they are doesn't mean what they are saying is fact... fact needs to be backed up by HARD EVIDENCE!!! I point to the most recent example of this where a well known doctor came up with the MMR conspiracy theory and linked it with autism. WITH NO HARD EVIDENCE. Unfortunately he shouted loud enough and got enough people listening... now look at what is happening because of this.

4) Who funds the research? This varies, some is by medical councils, some WILL be by drugs companies. Why? Obviously they will have a bias towards getting a medicine they want to get approved. Drugs companies DO fund research. This is vital, if they didn't who would?? They spend millions each year on research into drugs that never get lisenced, why because independent specialists assess their information and do not feel it is clinically justified. Yes literally millions they spend, only a tiny proportion of drugs they research are ever lisenced. ONce they are lisenced they have gone through multiple trials, rigorous testing and assessment by INDEPEDENT specialists. Obviously once lisenced there will be a huge investment and push from drugs companies to get people to sell their drugs. I point this out that just because a drugs company funds research doesn't necessarily mean it is a conspiracy at the highest level, this funding is vital and drugs wold not be lisenced without this.

5) If you have symptoms of problems AND are on medication, do NOT immediately jump to the assumption that this IS BECAUSE of the medication, consider it for sure, suggest it to your doctor, shout it if you feel you are not being listened to but realise also that it could be due to other problems and the fact it started after your medication deosn't mean that caused it. I point to a situation I found myself in at work (i'm a vet) I had a seeemingly health 4 year old cat with no prior history sat in my waiting room waiting for a vaccine. They cat suddenly and entirely unexpectedly went into cardiorespiratory arrest. This turned out to be due to an unknown clot. Had I had this cat in and vaccinated it and this happened immedaitely after you can guarantee the assumption would have been the vaccine had caused it, clearly that assumption would have been wrong.

I could go on about this topic for ages and i'm sure everyone will as ever have their own thoughts. What I want to provoke is stimulation of people to have their own thoughts and appreicate that nothing is EVER BLACK AND WHITE. There are always shades of grey. What we simply need to do is appreicate that htis is the case and consider the above things when trying to suss out what we believe and don't/

I write this as I was frustrated today by a member on here who presented their thought as FACT and became extremely derogatory and patronising towards another member who had a different opinion and insinuated they should look at something they presented as fact and they would change their mind if they knew what they were talking about. What they neglected to realise is the member they patronised had done thorough research already and did know what they were talking about.

Please don't allow yourselves to be patronised on here, never assume because someone is convincing that they are right, listen to all viewpoints, make your OWN MIND UP and try to ensure this is balanced.

I say this as a person who has suffered with cholesterol related issues for 16 years, I have extensive scientific training, I have made several lifestyle changes alongside medical therapy with my decisions being based on thorough research into BOTH sides of the story and in conjunction with other medicial professionals and specialists in the field.

I hope for those of you who are looking for answers this helps you know how best to go about assessing the information you are given.

[Mike262]

You need to use your judgement on the quality of evidence provided by Web Sites( its a bit more than a google search) and I would suggest you go to evidence.nhs.uk or patient.co.uk for validated evidence or try the British Heart Foundation Web Site. You need to look at the size of the relevant study to ensure it is large enough to substantiate and prove its findings. Beware the sort of so called experts like the one who produced misleading findings about MMR leading to the current measles epidemic in South Wales.

[ElleC]

Thanks Traci, I'm frustrated about this aswell hence writing this. I worry that ppeople will be unduly swayed by sensationalism when the are genuinely needing balanced advice. X

[ElleC]

Bigleg you misinterpret me. I am happy with how to critically analyse references and research trial data. My post was aimed at arming other people with some ideas of how to do so and to encourage them not to take everything they read and hear st gave value. Thank you though for your input and references i will certainly have a look.

[betabalance]

Great post ElleC,

I always try and differentiate in my own posts what is "my opinion" and what is generally recognised science (not that this can't be questioned too). As an industry professional it can be difficult as, is the case with all things, we have to take an opinion - something that sometimes isn't fully appreciated. No one knows everything there is to know and everything that there ever will be to know on a subject. I posted recently on the rise of "rouge doctors", at least a full clinical trial has to go through an ethics committee and then be peer reviewed - not just ramblings on a website. They are pretty much always too extreme - they have to sell books or create a following.

Now I have some of my own non-establishment views. I certainly don't recommend low fat diets and statins for all. I always feel lifestyle improvements should be made first and I have strong beliefs as to what those could/should entail...

But I too am frustrated by some recent posts/posters. When a new person comes to the forum asking for advice on how to lower their cholesterol they should not be taken off on a tangent saying that they shouldn't bother. You have to ask what kind of socio-path comes to a cholesterol forum if they don't believe that raised cholesterol is a problem. They are quick to point out the damage that the big bad drug companies may or may not do - what if the 3rd party information they pass on is wrong - what damage are they doing from behind their key boards?

If someone asks for advice on how to lower cholesterol through diet. Give them your opinion on that. It's fine (and constructive) that there are different opinions within the community. But you should not hijack it with a completely different agenda.

BetaBalance

[betabalance]

Woa...Concerned. I think you have me all wrong.

Having read many of your posts I know we share many views on healthy eating/lifestyle e.g. processed foods, carbohydrate intake etc...

I also above encourage input and different opinions in this community (as I state above).

The thread by the original poster (and my post) is about critical analysis - how it should be encouraged and why it is just a good thing. I am as critical of drug research as I am some guy's book or website.

No where am I saying respect drug companies (but equally) I am not saying respect a quack who runs a website. Read both, look behind them at teh research, and come to your own conclusion.

What I hate most of all is a "lazy" reader - who reports something 3rd hand as being fact to someone who is new to the area. Which I believe is how this thread came about. N.B. I am in no way suggesting this is something you do. Concerned.

A 'hurt' BetaBalance

[sandybrown]

Very interesting!

If NHS and other bodies do not want to takepart in documentries to put a point forward, "Why HNS is giving pout medication?" and "HEART UK may not want to upset givers?", there is a lot to say about data from research and information avaliable to us. There was a short video clip, (no slot, no fat, no sugar, no milk and so on), then waht do you eat to live!

[gillyflower88]

I,m just confused by all the differing opinions and various " findings". Wouldn,t it be a relief if someone could come up with one definitive answer. I,m not on statins and wade through life wondering if I should/could eat this and that . The worry will kill me before a cholesterol related disease.

[ElleC in reply to gillyflower88]

Hey chino. I totally agree that it would be a relief to get a definitive answer... However there currently isn't and that's my point. What's great though is the information id outthere you can critically analyse it and draw your own opinion in your path. I appreciate knowing what to do is worrying when it comes to your own health as I've been there myself. However I encourage you to be empowered by the ability to critically analyse the true wealth of information that is freely available and draw your own conclusions.

[Aliwally]

I agree with Chino but I'm glad Elle C has started this interesting debate!

I did think that one of the responses to the question about coming off statins prior to conceiving was inappropriate and I wish I had said so at the time. However, what I like about this forum is that the opportunity to express all views is here. This makes it quite different to blogs from Drs Briffa and Kendrick (who I also read with great enjoyment and interest) and the Facebook FH site.

I take Elle C's point about fact and opinion and working in education, correct referencing is the golden rule, that is why, like Beta I always try to say "in my opinion". Over four years of reading about the statin debate, I know within the first sentence which side of the fence the author is on and it is the same on this site.

Andrew Wakefield's research has been rightly discredited but other people have gone against "mainstream thinking" and been proved right. I am thinking of Anne Diamond and her campaign against putting babies to sleep on their tummies and Barry Marshall and Robin Warren who discovered the helicobacter pylori bacterium.

Final reference " The clinical community however, met their findings with scepticism (sic) "

ncib.nih.gov/pmc articles.

Let's continue to debate but accept that other people have different views while being aware of fact and opinion.

[Aliwally]

The above web site wasn't a link, just a reference!

[sandybrown]

Two years ago I was told I have high blood sugar level and high cholesterol and I need to go on medication! I am afraid there were no definitive medication, number of medications were available. On the other side life style change. Went for life style change and managed to lower blood sugar level but not cholesterol (WHY? cholesterol will not come down, no one is able to answer it). I spent day and night on the web reading lots and lots of interesting information.

May be my age, family history (which is not available as they were not recorded). All GP wants me to do is to go on medication for cholesterol; this is because of NHS way. I will try cholesterol medication for six months, if there is no change in levels, so be it will accept life as it is.

ElleC, Thanks for starting this debate.

[ElleC in reply to sandybrown]

Unfortunately GPS are a tad restricted by nice guidelines. This is a slight situation of one size fits all advice. As such in the majority of situations the advice your gp will give you will work as this is the case the majority of the time clearly the majority isn't ALL of the time. Lets not GP bash as they are GENERAL practitioners and as such in general their advice is suitable. Clearly for some the one size fits all doesn't work. If you find yourself in this minority it doesn't mean they're wrong it means you're the proportion that doesn't respond as the majority do. In this situation and as a general rule anyway do your own research and devise a plan that works for you based on this and discussion with your gp. If your gp isn't open to discussion then is the stage you question their wisdom. A true scientist invites open discussion and debate and consideration of all sides of a theory.

[ElleC in reply to sandybrown]

Bala have you been checked for FH? Maybe worth asking your GP for a referral to a lipid specialist? Great that you've sorted your blood sugar levels. I hope trialling the medication goes well for you...

[malcolmp]

I would just like to apologize to Traci and Elle c for offending you both.At the end of the day we may have differing views,but we should not seek to impose them upon other people.

[ElleC in reply to malcolmp]

No. Indeed we shouldn't. I'm glad you see this. Clearly we have different opinions... That is the point. They ARE OPINIONS. Not fact.

[ElleC]

I'm truly delighted that people are welcoming this debate and discussion. We will never all agree that's the beauty of the free world we live in but i am happy that a few more people willknow to question something that may be presented as factual. If anyone else can continue to add their thoughts on how people should analyse what advice they're given i welcome that. I really think this might help people.

[patch14]

I have various personal reasons for not wanting to go on any drugs whatsoever unless without them I will die within weeks! I have found a way, myself, without the help of GPs to keep healthy, eat well and have low BP and am happy with my Cholesterol and BMI. I sometimes "chat" and "make suggestions" on this forum if I think I could give some advice, advice that the recipient may, or may not, take up. I don't, at least I don't think I do, lecture or threaten. I think that is appalling. I am sad that I have seen such poor help coming from GPs and Consultants that appear to frighten and misguide patients into believing that only their way is best. It is also very sad that there are people using this forum for their own misguided uses. This website was set up to guide and inform. I hope that we all take that on board and continue to do just that. Go well, all of you, and good health.

[foodblog]

When I was growing up the GP's advice and opinion was pretty much taken as gospel because the rest of us had very little - if any - access to medical research and information. Now with the internet we are all supposed to be hyper-informed about all aspects of our health. This can be infuriating for GPs, so I am told, when patients arrive with their own diagnoses and treatment plans. On the other hand, considering that one gets 10 minutes at most for the consultation perhaps we are participating in a different way now with the GP. Once the family doctor knew your whole family - and therefore medical history - but now you may see a doctor you have never met. So that puts a lot of pressure on us non-medically trained consumers of health services to do our research and be pro-active. Trouble is that the internet is flooded with some brilliant and some very dodgy reporting on studies and trials. And even the trials are not 'neutral' so how do we begin to make sense of our own conditions and how best to proceed? Excellent post ElleC.

[Penel]

Thank you for your post ElleC. I have been very interested to find out about conditions like FH, which I did not know about, having visited this site to look at controling cholesterol. I have an autoimmune disease which can only be controlled by diet, and it is very easy to end up overweight with high BP and cholesterol.

One of the problems, or strengths, of science is that there are often no definitive answers, only 'best fit' at the moment. Human biochemistry is very complicated and the role of cholesterol in the body is complex. It is not surprising that there are many different opinions when there are many different scientific views on the same subject. Even looking on a site like PubMed will show studies giving opposing conclusions about the causes and significance of cholesterol levels.

I found this article in the Scientific American journal giving a brief history of the cholesterol controversy and the role of statins, which I hope people may find informative.

blogs.scientificamerican.co...