With well over 25,000 visitors per month to THCB, undoubtedly many are not well grounded in critically looking at published research studies. This, of course, also is true in the media at large. With the recent publication in the American Journal of Public Health of a study touting the relative greatness of the Canadian healthcare system over that in the United States, I thought it would be valuable to share an appropriate way to begin to look at published studies.
As an aside, remember to distinguish scientific studies from opinion pieces (like those found on THCB). In opinion pieces, the writer is, of course, expressing an opinion, though the opinions can certainly be based upon facts.
Ok. The first thing you do when looking at a study is: read the title. This is generally what will (or, more likely, will not) get you reading further.
What next? Find out who wrote the study. Biases of researchers are very hard to overcome. Many researchers have devoted their professional (and activist, in many cases) lives to promulgating certain points of view. Sometimes these views are heretical, and the researcher finds himself (or herself) at odds with nearly everyone else in the field.
Now that does not mean the researcher is wrong. Case in point is Dr. Stanley Prusiner’s discovery of prions—better known as the agent responsible for Mad Cow disease. Dr. Prusiner suffered the withering criticism of nearly everyone for years until it looked like he was right. Now he is the proud owner of a Nobel Prize.
But I digress.
In the aforementioned article, who are the authors? Dr. David Himmelstein, Dr. Steffie Woolhandler and Dr. Karen Lasser, all of Harvard.
I had the pleasure of interviewing Dr. Woolhandler on my program. She is very well spoken and articulates her views very well. But she (and Dr. Himmelstein) is one of the founders of Physicians for a National Health Program. For nearly two decades, she has devoted much time and energy to pushing the concept of a national healthcare system in the US (Canada-like).
Do you think that this bias might creep into the study design? Would you be suspicious of a drug study that was funded entirely by the manufacturer of the drug?
After you get the names of the authors, you must find out if they have any potential conflicts of interest. This will generally be found at the end of the article, where a single-line biography of study authors are found. The much-maligned-here-at-THCB American Medical Association has been a big proponent of financial conflict-of-interest disclosures in publications. And financial disclosures have become the standard in most scientific (or nearly scientific) journals.
But what do we find at the end of the AJPH article we are discussing? Nothing implying the depth of ideological fervor of the authors. Not even a mention of the association of the authors with PNHP.
And this is wrong- because it implies that the authors of the study do not have a potential stake in the study’s outcome. It is no different than a drug or implants study funded by the manufacturer. It does not make the conclusions necessarily invalid, but it sure does bring them into question and worth corroborating independently before they become headline news.
In this, the internet age, when you hear about a study in the mainstream news—use your considerable internet acumen to do some brief checking up—find the study, find the authors and find out if there could be a major conflict of interest. Then check out the ‘rest of the story’.