Beyond Clickbait and Headlines: Viewing Research Studies with a Critical Eye
“Study Finds Red Wine Compound Slows Aging in Muscles and Neurons”
“Can Exercise Help Cut the Rate of Breast Cancer Recurrence? A New Study Shows it Might”
“New Study Shows Colon Cancer in Millennials is on the Rise”
“Babies Cry More in UK, Canada and Italy, Less in Germany, Study Finds”
“Study Shows Many People With Specific Nut Allergy Don’t Have to Avoid All Nuts”
It seems to be that there’s always a new study being shared online. All of the above headlines are real, and they are all just from the last 2 weeks. Have you ever seen a sensational headline with a bold declaration, and just taken it at face value? Let those days be over, friends! Good-bye, clickbait! The details about each of these studies matter. In the spirit of science, I’m here to help you think through the process of looking at research findings with a critical eye.
I wonder what it says about me that I’m a little disappointed when I come across new medical research that goes against what I have believed for a long time to be true? Why should I have FEELINGS about this stuff? I should be EXCITED about new breakthroughs. I mean, last time I checked I wasn’t especially narrow minded and I don’t think of myself as hugely rigid in my thinking or anything like that. I’m a scientist, right, so I’m supposed to embrace new knowledge and be all open minded and everything. Well, recently I found myself vaguely annoyed at a newly published study that investigated the use of asthma inhalers with and without spacers. A spacer is a tube-like device that you attach to your inhaler and breathe into and out of, inhaling the medicine slowly. These have been shown to improve the delivery of the inhaler medicine into the lungs, instead of just spraying the mouth (which is not helpful in asthma as you can imagine, since it needs to get to the lungs where it can work to open the narrowed airways). A research group from the United Kingdom found that in two groups of people ages 12-80, one group prescribed an inhaler with a spacer and the other group prescribed an inhaler without a spacer had no difference in numbers of severe asthma attacks. In other words, using a spacer or not didn’t appear to matter in this study. Sort of a shocker for me, since I’ve grown up in my medical career BROADCASTING FROM EVERY ROOFTOP I COULD FIND that you’d better use a spacer with your inhaler or else your asthma medicine doesn’t have a chance of getting to your lungs, where it needs to go.
I could feel my professional mood going south and then I told myself I’d better cool it with the emotions, pull it together and think like the scientist that I (mostly) try to be. I’m no varsity level academic smartypants by a longshot, but I do try to read medical journal articles with a little bit of a critical eye, so I thought I should try to do that here.
First of all, this study population isn’t exactly representative of my own patient population.
I see many wheezing children under the age of 12, who I know firsthand cannot use an inhaler correctly when they spray it directly into their mouths. Second, as I read closely, I noted that the authors stated that it wasn’t clear whether or not the study group (those who were prescribed a spacer to go along with their inhaler) actually used the inhaler or not. So it may, in fact, be difficult to draw any conclusions about asthma outcomes in this research, because we don’t know if the spacer group actually used the spacer! Man, that’s confusing. And deciphering new research studies is often that way. They are routinely misread and misinterpreted. Most good researchers transparently acknowledge any limitations in their study, but at the end of the day it’s up to the readers to side-eye the data and critically interpret the results themselves. In good journals, this is already mostly done for you because they are “peer reviewed,” which means that colleagues in the same field have already taken a pass or two at the analysis. In my little ol’ opinion, it’s still hard, but in my own final analysis, I decided that this new research would NOT burst my practice bubble since it didn’t exactly prove that spacers don’t help young kids, which is my primary interest.
I’m not looking to trash talk these researchers. Not at all.
They are asking important questions and not just accepting the status quo, and we NEED this in science and medicine. I’m not even trying to continue my pro-spacer bandwagon with this blog entry. What I’m really trying to do is share my thought process on how to APPROACH thinking about new research, so that when new studies come along, you won’t react immediately on any end of the spectrum of either total acceptance or total denial.
When new research is published, I think it’s important to reflect on the data and ask yourself these questions—
- Is the study question worthwhile and does it make sense?
- Who is getting studied and is it the right population?
- Are the results reasonable and do they answer the research question?
- Is this a funded study? If so, by whom?
- What was the sample size?
- What are the limitations of the study?
- Can the results be applied elsewhere?
- What are the next steps?
Of course all my academic scientist friends have much more detailed questions and answers than those listed above (and the statistical stuff- GAH!), but I think that if I can process new studies thinking about these questions, then I might assess them better and interpret new research more accurately and robustly. Maybe you can think about these questions as well the next time you read about new research or hear about cutting edge study results on the news, and you will be more accurate in your interpretation too. Anyone who wants to spend a little remedial time helping me understand the statistics side of things, just let me know. I’m available.