Research Smeesearch: Identifying Problems in Evidence-Based Medicine
Whether you're new to MoveU or a long time follower you may have noticed that we're a little different. We like to have fun, that's obvious. But, we are also very serious about shaking up healthcare, specifically pain. We poke fun, we challenge and are brutally honest when it comes to the shortcomings of our current system. We're bringing to light that research shouldn't guide your daily life. However, research is critical to advancing science and medicine. Basically, take scientific studies with a grain of salt when it comes to your day-to-day.
We understand that this may be longer than you have time for but we had to be thorough. We wanted to ensure that we cover each of the issues surrounding research and evidence-based medicine.
Don't let the name of this blog fool you, evidence-based research ABSOLUTELY has its place. Think of all the significant medical advancements we’ve made that have started with pure science: anesthesia, vaccines, and antibiotics to name a few. However, we feel the need to raise awareness about the issues surrounding research and evidence-based medicine.
That’s why we’re bringing you something new!
Welcome to MoveU’s Research Smeesearch.
The goal of this ongoing series is to draw attention to the issues we are confronted with continuously from our audience, peers, and critics regarding research and evidence-based of medicine.
Show Me The Studies
“I read all the research.” “Please provide your evidence.” “Your claim is unsubstantiated.”
We get these all the time. But have you ever questioned where the studies come from? You know the saying there's an app for that? Well, now there seems to be a study for that.
That's right, companies can buy studies! Oh and if the study comes back negative, researchers can tinker with the variables until they've gotten a favorable result. That’s not a joke, it’s a real problem. And the problem runs more rampant than you realize.
But this is what we’re challenging. Throughout these posts, we will be showing you how the media uses studies to increase revenue. We’ll be shedding light on how anyone can find research to fit their platform, argument, or sell their product.
We’re here to show you the problems with the evidence-based medicine model, as well as break down data collection. We'll also learn how to develop a critical eye for a flawed study, or one that was funded by a biased party. And lastly, we'll look at “Bad Science.” The epidemic of negative or unfavorable results that isn't published or deliberately hidden from the public.
To be clear, we won’t be diving into the science here, as we are not researchers. Our only intent is to help our audience make more informed decisions, develop a more critical eye, and learn how to apply the current evidence-based medicine to your daily life.
Headlines Vs. Actual Studies
News: ‘How that Cup of Coffee is Saving Your Life’ Radio: Tune in Next Week to learn ‘How Your Cup of Coffee is Killing You.’
News agencies run on views, clicks, and advertising dollars. The results are cherry picking, omission, and sensationalization to garner revenue.
The result? Individual research findings begin to carry a lot more influence than they should.
Researchers, academics, and professionals should be using research to better humanity’s understanding of the world. We are meant to learn from these studies, not take them at face value and make life decisions from them. So it would help if you didn't use these studies to make decisions about your everyday life.
If these studies are meant to educate, why shouldn’t we use them?
For that exact reason: they’re only meant to educate.
The point of science is always to be questioning the world around us. Therefore, a study could come out today saying coffee is good for you, but tomorrow another study could come out saying it’s bad for you. Take the above headlines from the SAME news sources.
The foundation of the scientific method is being able to replicate or disprove any experiment. Therein lies the problem with using singular studies to make life decisions: tomorrow the opposite information could be in the headlines.
And there is absolutely nothing wrong with scientific studies contradicting each other. That’s exactly what they should be doing! But if you live your life by them, you're going to be throwing away and rebuying a lot of coffee.
Well, theories are just theories. Just because one study came out saying coffee is healthy doesn’t mean that’s the answer. It means that we *think* coffee is healthy now because of a certain set of circumstances.
“You've heard of our greatest scientific theories: the theory of evolution, the Big Bang theory, the theory of gravity. You've also heard of the concept of a proof, and the claims that certain pieces of evidence prove the validity of these theories. Fossils, genetic inheritance, and DNA prove the theory of evolution. The Hubble expansion of the Universe, the evolution of stars, galaxies, and heavy elements, and the existence of the cosmic microwave background prove the Big Bang theory. And falling objects, GPS clocks, planetary motion, and the deflection of starlight prove the theory of gravity.
Except that's a complete lie. While they provide very strong evidence for those theories, they aren't proof. In fact, when it comes to science, proving anything is an impossibility.”
Mic Drop, Exit Stage Left, Class Dismissed.
Just kidding but hopefully, you are getting the idea.
Science is Never Done
Doctors continue to ‘practice medicine’ because it is always evolving. What was the best practice yesterday can be harmful tomorrow.
And we can’t prove or disprove anything if we don’t even know there’s an issue or question to ask in the first place. For instance, the act of hand-washing in hospitals is only about 170 years old. It was discovered not by a study, but by one man.
Doctors would perform an autopsy in one room and deliver a baby in the next, often killing the baby. This led to a hypothesis and ultimately the creation of Germ Theory. But think about how many more babies would have died waiting for the evidence stating physicians need to wash their hands between patients?
Contrarily, NSAIDS like Tylenol and Ibuprofen have been deemed safe for decades, even for children. But now the FDA mandates they carry stroke and heart attack warnings! Why didn't a study find this out before being brought to market? Because we didn't know to ask if these were safe for long-term use!
What this means is that a study isn't the finish line; it's merely a checkpoint. We will always be learning how our bodies work and interact with the world around us, and we shouldn't rely on one tool for the answers.
The Media's Effect
Now that we know a little more about the limitations of science in general, let’s address the problems currently plaguing evidence-based research in medicine. It is important to note that research is not created equal and that’s partly egged on by the media.
Whether it's the New York Times or your high school friend on Facebook, news and social media far too often blur the lines of what has been proven as fact and what is speculative, or merely preliminary research.
Read enough studies and you'll start to notice the trend that most of them end with something like “More research will be needed,” however, you’ll rarely see that reflected in a headline and never in your friends' social media post.
The study may show that the subjects had slightly improved markers for brain health, and it specifically states that more studies will be needed to confirm. When a media outlet gets a hold of the study; however, they tend to use language like “Coffee Proven to Have Brain-boosting Benefits.”
A more responsible headline would read “Coffee May Show Promise for Brain Health.”
But that just isn't as sexy is it!?
Knowing the source of your information is the most important thing you can do in regards to educating yourself. Skip the headlines, click through to the study, if they even link to it.
Publication or Sponsorship Bias
Also known as the ‘File Drawer Effect,’ this involves studies showing a negative or null effect never being published. This is potentially the biggest problem plaguing research because it’s at the core of the process. Positive findings are 3x more likely to be published than null or negative results.
Our Coffee study showed a positive result, so the study got published. Now, what would have happened if the study came back negative or null (no difference compared to placebo)? It most likely would not have been published!
Let us say we had ten studies that showed no brain-boosting benefits of coffee but because these were never published the public doesn't know about them. That's like one friend saying coffee is good for you, while ten friends are screaming it's not, but they are in a hidden room where you can't see or hear them. THIS IS A PROBLEM!
Data Collection & Observational studies
The next issue is a bit more complicated.
What type of data was the coffee study based on? Was it brain scans, interviews, surveys? Were the test subjects people or rats? Was this a double or triple blind placebo control study looking specifically for the neurological benefits of coffee? Or was it an observational study that noticed people who marked their survey as coffee drinkers had less incidence of Alzheimer's (correlation not causation).
The context of the study, the method of data collection, interviewer bias, the observation effect, all of these and more can influence or skew data towards a particular outcome.
Funding Bias or Sponsorship Bias
Yes, there is even more that can be wrong with our coffee study, like who paid for it? Was it the National Institute of Health (NIH) or Starbucks?
This matters because who knows how many null or negative studies they paid for before they got a positive result to publish.
This problem is especially rampant in the pharmaceutical, medical devices, supplements, and food and beverage industries. Here, a positive finding for a drug, piece of medical equipment or a product can mean millions and sometimes even billions of dollars.
Evidence-Based Medicine model
In their paper ‘The Evidence for and Against Evidence-Based Practice,” the authors opening comment provides an excellent summary of the issue at hand:
“Evidence-Based Practice has been both heralded as one of the major advances in health care, promising to revolutionize both policymaking and practice. While simultaneously ridiculed as a development that will reduce professionals to mindlessly (and soullessly) following recipe books for the betterment of insurance companies.”
So What Does That Mean?
In the current evidence-based practice model of medicine imagine our coffee study is used as ‘Current Best Practice’ by physicians and hospitals for brain health. That simply means that if you went to your doctor and you fit the criteria (often set by insurance providers), your doctor would be forced to recommend a certain treatment option that fits what the study finds.
Basically, a Starbucks coffee would be your treatment plan for your brain health.
Your doctor is guided by these studies and unable to advise you on alternative healthcare methods because they may or may not have evidence to back the claim. For example, drinking enough water and getting 8 hours of sleep may be just as effective for brain health, but your doctor wouldn’t be able to recommend it because there’s no “evidence.”
Just because a solution to a healthcare problem is common sense doesn’t mean that it’s the answer. If there’s no evidence to back it, a physician can lose their license for prescribing or even mentioning it!
The Problem with Evidence-Based Medicine
That’s the problem in a nutshell; the healthcare industry is set up to help the masses, not the individual. More detrimentally, it is set up to serve the hospital, drug manufacturers, and insurance providers, not the patient. Is it any wonder we are sicker than ever?
MoveU is by no means discounting the importance of science and evidence-based practices. However, we feel the need to challenge the status quo, and that is to say that there are problems with how some of it is conducted, presented, and implemented.
As Michaelangelo is credited with saying “criticize by creating,” we could have stayed in our lanes and complained about the current state of things while doing nothing.
But that's not our style.
The MoveU program was born from hands-on-experience working countless hours one-on-one with individuals dealing with pain. Through this, we were able to develop an online resource that teaches people daily practices to reduce their chronic pain. Some of our program is based on what you would find being prescribed in any physical therapy office but there is a lot that you won't find.
And that's what makes MoveU different.
Nowhere else will you find a community of support from members who have been in your shoes, who can share personal experiences of what did or didn't work for them. You won’t find a place in healthcare where you receive constant feedback from coaches on your movements while ensuring your mental and emotional health are in line with your physical.
It's the perfect merger of evidence and anecdote.
We would not be where we are today without the education and resources that science provided us. However, when we look around at the current state of chronic pain in our country, an opioid epidemic, and potentially insolvent healthcare industry, it is clear to see there is massive room for improvements.
We Demand Better Options and so Should You!
Sincerely, We thank YOU for reading. We also must thank our incredible family of MUvers, who continues to shock us with their transformations and heartfelt messages, they are the only ‘evidence’ we need to keep Fixing All The Shit!
If you want to learn more about how MoveU is challenging healthcare with a new approach, click here.
Written By David Schroer