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Studying a Study and Testing a Test is a book that can greatly enhance ones ability to critically read and evaluate biomedical literature. It is essential for anyone who is serious about studying medicine. Page Creation |
Health is a multi-billion dollar industry and both conventional and alternative medicine are fighting for as much of the pie as they can get. Separating the facts from the alternative medicine hype and the dirty politics of the medical establishment can be extremely difficult. And, as if that's not bad enough, obese people also have to separate the facts from ignorance and prejudice. How in the world can we find the truth in this toxic sea? Thanks to the Internet, we can now read medical abstracts for free. (In the bad old days you had to search by modem and pay time and character charges.) But when you get a bunch of medical articles, how do you evaluate them? What do you do when some of the studies disagree? How do you determine the strength of the data? Does the author draw conclusions that go far beyond the boundaries of the observed facts and the current knowledge base? Is there a design flaw that casts doubt on the results? Understandably, a lot of people don't want the hassle of sorting it all out, so they buy a health book and assume that the writer has put everything in proper perspective. Some writers do an excellent job, but unfortunately many books -- even books with medical references -- are dubious. All too often writers avoid the painstaking work of evaluating the totality of the research: some writers limit their focus to studies that can be used to support their position; others limit their focus to the most recent studies. It would be nice if real research could be so easy, however, if a new study gets a result that is at odds with a well established finding, it is a mistake to assume that "the latest must be the greatest." In fact, when this happens, the "Methods and Materials" must be carefully examined and the results must be reproduced by independent laboratories. Sometimes this follow up work is never done and you end up with a study that directly contradicts the established research. All too often, this aberration is aggressively exploited for marketing or political purposes. This situation is difficult for both health writers and the people who just want to cut through all the opinions, hype and politics. Although I can sympathize with people who don't have time to do in-depth research, the fact remains that there really is no shortcut around the difficult task of learning how to evaluate study design -- and taking the time to look at the big picture. In many cases, learning even a little bit about how to evaluate study design and statistics can prevent you from being led astray and save you a lot of money. "Studying a Study and Testing a Test" is a book that can greatly enhance ones ability to critically read and evaluate biomedical literature. It is essential for anyone who is serious about studying medicine. This book can teach you how to assess, analyze, interpret and extrapolate. This is where the "art" of medicine comes in to play, but it is also where many errors occur. This is what separates the brilliant mind from the robots with good memories. As Riegelman points out:
Although it is a well written book, it is not an easy read. In fact, physicians can earn CME hours (continuing medical education) by studying this book and CD-ROM. Why should a layman go to such trouble? Well, given the realities of the health care turf war, there really is no good alternative to self-study. Alternative medicine ranges from bogus to miraculous; conventional medicine ranges from deadly to miraculous. Who is gonna objectively tell you about ALL of the available treatments? How many doctors tell their obese patients about ECA, or their heart failure patients about life-saving supplements like coenzyme Q10, carnitine, and taurine? By the same token, how many alternative practitioners tell people when conventional medicine is the only rational choice? Walking the path of self-reliance is an awful lot of work, but I don't know of any reliable short cuts. Although this book is great for advanced readers, it probably should not be at the top
of the list for people who are just starting to read medical literature. First, get
yourself some good texts on anatomy & physiology, endocrinology, pharmacology . . . oh
heck, read all the "ology" books.
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Seriously, though, you need to build
a solid base of knowledge before you start worrying about picking studies apart. But if
you're ready for it, I highly recommend this fine book. Like they say in Zen: when the
student is ready, the teacher appears. If you're ready, this book is an excellent teacher.