I’m pretty sure Jonathan Howard, M.D., is not psychic — but I’m not 100% sure. After all, almost nothing in science can be stated with 100% certainty. But I could be forgiven for suspecting he had some sort of premonition about the pandemic and the massive challenges it would present to clinicians, researchers, journalists and the public at large, because of the book he published less than two years ago: “Cognitive Errors and Diagnostic Mistakes: A Case-Based Guide to Critical Thinking in Medicine.” (Before you read any further, be aware that I have disclosures related to Howard that will become evident shortly.)
Physicians in all fields of medicine rely on guidelines developed by professional medical organizations to inform how they care for patients. These guidelines, whether defining what counts as hypertension or laying out how best to care for pregnant women, constitute the standard of care in that particular field. To call them influential is a huge understatement.
Since most of these guidelines discuss treatments, it’s reasonable to pay attention to whether those writing the guidelines might have a bias for or against a particular treatment that’s not based on evidence. It’s impossible to be certain of this for all guideline authors, but ensuring they aren’t receiving big checks from industry is one way to guard against bias. Continue reading
How much does the way you cover a study matter? If we judge that question on the basis of how your coverage might influence a reader’s opinion about a treatment’s benefit, it matters quite a bit, suggest the results of a recent study in BMC Medicine that examined spin in news stories about clinical studies.
In short, news articles that included spin in their coverage of a study about a particular treatment were more likely to leave readers with a positive impression of the treatment’s benefit.
I’ve discussed in previous blog posts ways in which confounding by indication can completely change the way observational research is interpreted: it can flip common wisdom about labor induction and cesarean delivery risk on its head, and it can lead to bizarre conversations illustrating a researchers’ blind spots when it comes to discussing topics such as depression and hormonal birth control. Continue reading
I wrote in a previous blog about the importance of understanding confounding by indication and being sure to ask researchers about it when covering observational studies that appear to suggest a particular treatment or intervention might contribute to a specific effect. I’m passionate about this type of study bias because not considering it — which happens a LOT — can lead people to decline otherwise helpful treatments or leave them experiencing more harm and pain because of unfounded fears. Continue reading
More than 1,500 peer-reviewed studies have relied on a surgical database known as the National Surgical Quality Improvement Program (NSQIP), or its pediatric counterpart, the NSQIP-P.
These databases, set up by the American College of Surgeons, offer extraordinarily granular information about clinical variables and outcomes (as well as demographic information) for a wide range of surgical procedures. Continue reading