Tag Archives: lancet

UN, medical journal highlight oral care as a global public health challenge

Photo: World Bank Photo Collection via Flickr

Painful and debilitating oral diseases such as tooth decay, gum disease and oral cancers are estimated to impact more than 3.5 billion people across the globe. Yet nations have almost universally failed to grapple with this health crisis, an international team of experts has concluded.

In the first article in a two-part series, led by researchers at the University College London and published by The Lancet, members of the team explore the extent of the epidemic, which burdens nearly half the world’s population. Continue reading

Researchers agree: A study is a terrible thing to waste

Spend any significant amount of time reporting on research and you’re bound to run across a real stinker of a study.

Too often, the studies that become clickbait on the web or turn up in women’s magazines – usually boiled down to a surprising health tip – are just, well, how do I put this? Crap.

There are a lot of those kinds of studies in the world. Studies that are too small to be meaningful, or they ask bad or useless questions, they’re poorly designed or they essentially answer a question that’s already been repeatedly answered.

These kinds of studies exist because the publish-or-perish culture of academia rewards volume over value. And let’s accept our part in this, too. There’s always a media outlet that’s willing to trumpet a surprising, if completely unsound, study.

In a microcosm, a bad study or two can raise an eyebrow or a chuckle. In a macrocosm, however, the situation is dire. Continue reading

The downside of using big data in medical research

A scientific scuffle played out in the pages of the Lancet recently. At issue was whether a team of scientists led by Dr. Damien Cruse at the University of Western Ontario had successfully used EEG, a test that measures the electrical activity of the brain, to detect awareness in brain-damaged patients who were in a vegetative state, a finding they first reported in 2011.

Other scientists who were working on the problem of awareness had been gobsmacked by the results.

Patients in vegetative states eventually open their eyes. They wake and sleep. But otherwise they have little awareness of what’s going on around them. Some of their reflexes may still be intact but, according to diagnostic criteria, they don’t respond to commands or understand language.

To show that 3 out of 16 of these patients were able to follow verbal instructions to imagine opening and closing a fist or wiggling their toes at the sound of a series of beeps was “pretty impressive,” says Andrew Goldfine, M.D., a neurologist at Weill Cornell Medical College and Burke Medical Research Institute in New York. Continue reading

Critically evaluate, report on cell phone/cancer link

Courtesy of the International Agency for Research on Cancer’s press release and the storm of advance coverage it has spawned, you’re probably already braced for Lancet‘s imminent publication of the IARC’s report classifying “radiofrequency electromagnetic fields” as “possibly carcinogenic to humans,” otherwise known as the cell phone/cancer link.

Photo by mallix via Flickr

While you’re waiting, it’s worth taking a few minutes to put yourself in position to critically evaluate the study. The six-page press release is a decent place to start, but as Dr. Len Lichtenfeld, blogger and deputy chief medical officer for the national office of the American Cancer Society, reminds us, IARC is a respected source, but the science they’re reviewing is tricky and, at this point, it’s just a press release.

For background on the scientific debate, see Lichtenfeld’s commentary and Eliza Barclay’s post on Shots, NPR’s health blog.

If you don’t have time for the full press release right now, I have pasted what I consider the two must-read paragraphs below. The first summarizes what the working group found upon reviewing established science, while the second explains exactly how the scientists are currently classifying the possible link between cell phones and cancer. Between the two of them, you get a quick snapshot of the study and its implications.

The evidence was reviewed critically, and overall evaluated as being limited among users of wireless telephones for glioma and acoustic neuroma, and inadequate to draw conclusions for other types of cancers. The evidence from the occupational and environmental exposures mentioned above was similarly judged inadequate. The Working Group did not quantitate the risk; however, one study of past cell phone use (up to the year 2004), showed a 40% increased risk for gliomas in the highest category of heavy users (reported average: 30 minutes per day over a 10‐year period).

Group 2B: The agent is possibly carcinogenic to humans.
This category is used for agents for which there is limited evidence of carcinogenicity in humans and less than sufficient evidence of carcinogenicity in experimental animals. It may also be used when there is inadequate evidence of carcinogenicity in humans but there is sufficient evidence of carcinogenicity in experimental animals. In some instances, an agent for which there is inadequate evidence of carcinogenicity in humans and less than sufficient evidence of carcinogenicity in experimental animals together with supporting evidence from mechanistic and other relevant data may be placed in this group. An agent may be classified in this category solely on the basis of strong evidence from mechanistic and other relevant data.

For more perspective on what a 2B classification really means, see Katherine Harmon’s post on the Scientific American editors’ blog. Her key point is that “The May 31 announcement, however, doesn’t imply that cell phones cause cancer. It suggests that there are still enough unknowns not to rule out long-term health effects of the devices.”

Merrill Goozner expects the evidence to be murky and he concludes that IARC’s tenuous conclusion will be fully justified but also largely ignored by the public. He also points us to Lou Slesin’s Microwave News for solid reporting on the conflicts of interest surrounding the issue.

Finally, once the science is published and it’s time to file stories, be sure to refer to AHCJ’s guide to covering medical studies (membership required), where you’ll find all the tips and reminders necessary to ensure you’ve covered all the bases on this high-profile story.

Online guide focuses on covering medical studies

Covering Medical Research

Reporters are inundated with lures to cover the latest medical study or scientific conference paper. And there are some significant milestones being reached in medical research. But, more often, the information reaching the public is way too preliminary or even misleading, say those behind a new AHCJ reporting guide on covering health studies.

The guide will help journalists analyze and write about health and medical research studies. It offers advice on recognizing and reporting the problems, limitations and backstory of a study, as well as publication biases in medical journals and it includes 10 questions you should answer to produce a meaningful and appropriately skeptical report. This guide, supported by the Robert Wood Johnson Foundation, will be a road map to help you do a better job of explaining research results for your audience.

International cooperative to share health data

Writing that “the importance of data sharing in advancing health is becoming increasingly widely recognised,” 17 major public health players entities, from the CDC and AHRQ to the Bill and Melinda Gates foundation and the World Bank, have banded together to form a sort of data cooperative around the Wellcome Trust and the Hewlett foundation. In a Lancet commentary announcing the initiative, Wellcome director Mark Walport and Hewlett president Paul Brest write that, while fields such as genetics and molecular biology, a mature data-sharing system has sped up discoveries and increased efficiency, public health is lagging behind.

Much of the infrastructures, technical standards, and incentives that are needed to support data sharing are lacking, and these data can hold particular sensitivities. And some researchers are reluctant to share data. Too often, data are treated as the private property of investigators who aim to maximise their publication record at the expense of the widest possible use of the data. This situation threatens to limit both the progress of this research and its application for public health benefit.

Each organization will work within its own structure and their initial goals include the creation of data standards to facilitate sharing as well as increasing the prestige of creating public data sets. They acknowledge there will be some bumps along the way, but call on other organizations to join the initiative and to pursue the long-term goal of the widespread, fair and privacy-respecting sharing of public health data.