• Answer To Inquiry: How To Evaluate Published Medical Studies

    Posted January 1, 2013: by Bill Sardi

    Hi Bill,

    I have thoroughly enjoyed reading your articles and wondered if you could give me some advice. I don’t have a background in health but I really enjoy learning about it and want to develop a skillset that includes being able to review and analyze research articles and sum up those results.

    How did you develop this competency? Via education or experience? I am going to start by pulling some articles off of PubMed in a particular area and see if I am able to make sense of them and translate them into something I would understand in a quick read. Is there anything else you would recommend I do?

    Thanks

    Answer:

    Bravo! That would be a near insurmountable task at the beginning. But do-able over time.

    You would first have to grab a medical dictionary and use it in the beginning to understand nearly every paragraph you read. Medicine using its own lingo so you need to consult with and pay doctors. Modern medicine needs to be de-coded.

    You will run into words like “putative” (reputed to be) or “statistically significant” versus “clinically beneficial” (yes, but how many people have to take a pill to benefit?).

    You will run into the way statistical evidence is measured, called the p value. If the p value is 0.5 or higher then it is no better than chance. If it is 0.1, or 0.01, or 0.001, or 0.0001 then it is increasingly better than chance.

    It is important to learn the difference between relative and hard numbers. In relative numbers, statin drugs reduce non-mortal heart attacks by a third (from 3 healthy people who could develop a non-mortal heart attack over 5 years to 2 healthy people who would), but in hard numbers that is 1 in 200 people who would benefit from the use of statins (number needed to treat to prevent 1 heart attack over 5 years).

    You will run into the myth of the placebo (inactive agent). See my article DEBUNKING THE PLACEO EFFECT ( http://www.chiro.org/nutrition/FULL/Debunking_the_Placebo.shtml ) The bar is set low (you only have to be better than nothing) to become an FDA approved drug. Your medicine might be less effective than current drugs, but that will not be revealed. Then again, you will have to dig into what comprised the placebo. For example, plant dextrins (sugars) are often used as placebos, but they have recently been discovered to have therapeutic effect.

    Another problem is that placebo does not equate with zero effect. The body gets well on its own (most people recover from colds, flu, gall bladder attacks, headaches, hemorrhoids, etc.). This is called statistical regression.

    Now let’s say you conduct a short-term study of people who have immune or heart problems, and these studies just happen to be conducted in winter when vitamin D levels are low. But vitamin D is not considered. The drug may only be helpful among patients who are sun-deprived and then only effective in winter. But season of year is not considered in the analysis.

    Then you will run into dogma and ignorance and myths. For example, vitamin D is often mischaracterized as a cause of hyper-calcification. Yes, but that was determined in animal studies using 1 million units of vitamin D! There are however some issue with mega-dose D over the long-term because it is stored in the liver with all other fat soluble vitamins (A,D,E,K) and more D competes with storage of K. I began taking higher dose D to improve immunity and developed two eye infections due to lack of vitamin A. Once I began to take vitamin A (cod liver oil) twice a week the eye infections vanished. My personal experience trumped science!

    Another myth would be where you read that bioflavonoids (resveratrol, quercetin, etc) are not-bioavailable, or that they cannot traverse the blood brain barrier, when in fact neither of those are true. So then researchers assume mega-doses must be used, but mega doses are potentially toxic to the kidneys and other organs.

    Then you might have difficulty ascertaining the difference via dose between what is an anti-oxidant and a pro-oxidant (promotes oxidation). For example, vitamin C and resveratrol are anti-oxidants at low dose and pro-oxidants at high dose. Now the pro-oxidant state is not necessarily undesirable because as a pro-oxidant they selectively, without harming healthy cells, kill off bacteria and tumor cells. But nowhere does it say you don’t need to take pro-oxidant doses for everyday health. So that answer cannot be found in print, it has to be ascertained by analysis. High dose vitamin C transiently produces hydrogen peroxide (H2O2) which can kill pathogenic bacteria, and then becomes H2O (water), so it is completely non-toxic.

    Once you learn to navigate medical lingo, then you can navigate through the many falsehoods upon which modern medicine is established. You will learn that researchers pursue the development of analogs, molecular look-alikes of natural molecules, to produce patentable synthetic drugs in a get-rich scheme that has burdened medicine with undue high costs and produced avoidable side effects.

    For example, cholesterol-lowering statin drugs mainly work by mildly elevating vitamin D levels. The cholesterol-reduction achieved by statin drugs is toxic to the liver. Better to employ vitamin D. You would also learn, after much study, that calcium, not cholesterol, comprises the majority of arterial plaque

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