Sometimes, we read about a study result that is widely
publicized, yet we are reluctant to accept its absurd conclusions. I’m sure there are studies buried somewhere
that conclude that seat belts and bicycle helmets are dangerous and that
cigarettes prolong life. If such
studies do exist, they would face mountains of contrary scientific
evidence. In other examples, a medical
study’s conclusions may be false or misleading because the data are improperly
or inadequately interpreted. Consider
this hypothetical study. One hundred
patients with rheumatoid arthritis (RA) patients and 100 control patients are
questioned about their exercise habits.
Ten percent of RA patients exercise regularly in comparison to 40% of
the control group. The authors than
conclude that exercise might protect against the development of RA. There are many scientific reasons why this
conclusion is erroneous including the probability that RA patients don’t
exercise as much because they have arthritis.
In this simple example, you can get a glimpse of the scientific
vulnerabilities of many studies that are presented to us as dogma.
When we read a study whose conclusions defies reason or our
own life experience, we should summon up a generous measure of skepticism.
Be Skeptical. Think it over.
I have previously opined that adding an anesthesia professional
(AP) to the colonoscopy team enhances patient safety. So, when a study result was announced stating
that adding this professional to the endoscopy team increased short term
complications for patients, I paused to consider results that were contrary to
my own professional knowledge and experience.
Assuming that the data were sound, a patient might conclude that adding
an AP actually increased the risk of their colonoscopy and that they should
request a different mode of sedation.
If AP’s increase the safety of the endoscopy experience, as
I claim, then why might their use be associated with a slightly higher
unfavorable outcome rate? (Remember,
association does not mean causality.)
There may be several explanations for what sounds like an unexpected
outcome. Might it be true that AP’s are
called in to assist on sicker patients who, in general, have higher
complication rates for all medical procedures and surgeries? Similarly, a surgeon who operates on sicker
patients may have a higher complication rate than a colleague who chooses safer
cases. Does this mean that the first
surgeon is a riskier choice? Of course
not.
If a person or an organization is advancing an argument that
sounds silly, then maybe it is.
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