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The American Academy of Otolaryngology - Head and Neck Surgery encourage members
to send us information on research that may impact practice or patients. In
terms of educating patients when potentially concerning findings are presented
in the media that -have yet to have been replicated; do not account for the full
etiology of disease; or are not fully supported through a meta analysis of
related studies - the best approach is to educate them on research and science
in medicine. For a research study to truly impact changes in practice or the
decision making of patients, it must account for the full etiology (i.e. the
full set of factors that contribute to a disease) and have sound statistical
methods (meaning appropriate study accommodation for all risk factors and other
key patient profile information) and statistical power. If patients are
searching online, they should consider using PubMed to look at articles
published in peer reviewed journals to get a flavor from all of the summary
abstracts related to a search of the literature on a topic versus using basic
search mechanisms like Yahoo! or Google, which are not necessarily aimed at
looking for scientific evidence.
We applaud all research aiming toward the goal of improving practice and outcomes and the majority of researchers want their studies to be used as a means to an end and not be taken in an alarmist sense - it is hard to balance the excitement over potential links to understanding the disease process with the layman's interpretation of press release statements on research which are meant to be enticing and a grab for attention. An example follows to help physicians walk patients through a practical example of digesting press releases on studies:
There was a study recently presented at the American Association of Cancer Research that was picked up by Reuters. The press release was entitled "Tonsillectomy may raise breast cancer risk for some women" and opened with the following - "Women who had their tonsils removed in childhood may be at increased risk of developing pre-menopausal breast cancer." cancerpage.com/news/article.asp?id=10783
When reviewing a press release or media coverage of research like this with a patient, it is important to have them really read the article or release versus taking their cue from the title. In this case, the message of the actual text of the press release is not consistent with the title of the press release.
First off, the strongest statement made in the release is that "women who had their tonsils removed in childhood MAY be at increased risk of developing pre-menopausal breast cancer." Second, the press release cites the findings that "The APPARENT association may be related to the loss of the protective function of the tonsils when they are removed...ALTERNATIVELY, tonsillectomy may be the marker for severe or chronic infections in childhood - infections that cause inflammation , and chronic inflammation MAY contribute to carcinogenesis." The press release concludes with "The finding SUPPORTS accumulating evidence that childhood exposures ["exposures" not tonsillectomy] influence the risk of breast cancer in adulthood. FURTHER RESEARCH looking at the role of childhood infections [again, "childhood infection" not tonsillectomy] in breast cancer risk is warranted."
This study may very well be a sound analysis, and may be a preliminary step to important research findings in the future. However, we need to interpret the results in what seems to be the way the researcher intended - with a caveat for further study. In conclusion, the power of research can also be its downfall in some cases and in an age when patients are willing to be savvy consumers of healthcare, we need to educate them on appropriate interpretation of media and press release coverage of studies.
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