Tuesday, July 17, 2007

What's that study telling me?

How often have you read a news story that screams out that a there is a new drug breakthrough or a dramatic discovery? And how many times have you read a while later that the findings weren’t quite what they had been presented to be?

Many times, these stories arise from newly published studies in journals such as the New England Journal of Medicine or Lancet. Many journalists can get advance copies of articles from these and many other journals so they can prepare their stories for publication when the embargo is lifted. I’m lucky enough to get advance copies of some studies because of one of my clients. I write up articles geared towards journalists to create interest in the study findings. I enjoy this because I get to interview the lead author and another expert in the field while I prepare my story and I’ve learned some interesting things.

Unfortunately, some articles get published that seem to skirt the boundaries of informing the public of new findings and sensationalism. While it may seem that the studies are saying there is a new cure or a certain food causes cancer, rarely are studies that cut and dry. They can be, but it’s not common. The writer’s role is to understand what the study is saying without exaggerating the findings. Another important aspect to medical reporting is to use the correct wording, not to make absolute claims but to actually report what is being said. I have an advantage here because of my many years of a nurse and how we were taught to write in our patients’ charts.

There are some nurses who would write in a chart, “Patient slept well all night,” or “patient pain-free all shift." That’s a big no-no because it’s really not for us to say. It’s entirely possible that every time the nurse walked into the room to assess the patient that he was snoring away, and it’s entirely possible that he woke up moments later, only to drift off shortly before the next time the nurse checked in. Or, the patient may truly have slept all night, but didn’t feel refreshed or didn’t feel that she slept all night. The patient may have been in pain, but didn’t want to bother the nurse or felt that she could cope. The patients may say to the day staff, “I barely slept all night!” or “I was in pain all night.” But, when the day staff got report from the night staff, the nurse said the patients slept well or was pain-free. Thus, the importance of writing “Patient appears to have slept well all night,” or “patient sleeping at each round, appears comfortable.” It’s not incorrect to write, “Patient not complaining of pain,” or “patient denying pain.” This way, the nurse is writing exactly what is observed – not what he or she thinks is happening.

The same sort of thing exists with medical writing. If a new drug is helping a lot of patients, appears to be a cure of sorts, it’s much better – in my opinion – to write “Drug ABC Improving Life for Many Patients with XYZ Disease,” or “Drug ABC Appears to Cure Some With XYZ Disease.” I think it’s irresponsible to write a headline like “Drug ABC New Cure,” or “Patients with XYZ Cured with Drug ABC,” both types of headlines we have seen in the past.

When reading a study, it’s also important to understand how it’s being presented and if the findings are reliable. Is the study randomized? Is it blinded? Who sponsored the study? How big is the study group? There’s a huge difference between a study of 5,000 participants and 35 participants. Keep in mind, though, that some illnesses or injuries are not common so a study of 5,000 or even 500 would be virtually impossible. So, is the study of something that is fairly well known or is it of something rare?

What are the researchers looking for? Do they have one specific goal or was the finding an outcome that popped out of nowhere but was significant enough to be noticed? How long did the study take, if appropriate, and how long were the patients followed after?

There are many questions you need to ask yourself when reading these studies and one that some journalists and writers seem to ignore are, what are the weaknesses of the study? When reading a study, there’s a general format. The authors discuss why the study is important, how they went about it, how they calculated the results, the results, a discussion about the results, and a conclusion. In the discussion section, there should be a part about the study’s weaknesses. No matter how well planned a study, there are always some drawbacks. They could include study size (too small), subject choice (too homogenous, too broad), not long enough, too many surgeons performing the surgeries, and the list goes on. It’s essential that these weaknesses be pointed out so that the reader can decide how this may or may not affect how he or she views the findings.

Reading studies can be intimidating sometimes. I still read some that leave me wondering what the heck I’m reading. But if you plan on writing about a study, be sure that you understand the significant findings, why and how they came about, and how someone who isn’t involved in the study feels about the findings. This outside expert can provide a good balance.

News for today:
Older, cheaper diabetes drugs as good as new
Weight training can help with heart trouble: AHA
Many cases of Lyme disease going undiagnosed
Overcrowding leads to lung infections in Inuit


Terrie Farley Moran said...

Hi Marijke,

We both post on Dawn's blog and I've lurked here a few times. I just wanted to say how pertinent this post is. I try to keep up with the latest studies and have trouble cutting through the more sensational aspects. Thanks for pointing out that I am not alone. As a fiction writer I should be more aware of the "it's all how it's written" part of the study presentations. A snippet on the eleven o'clock news may get my hopes traveling in an entirely wrong direction.

And, I love your news links!


Marijke Durning said...

Thank you Terrie. I'm glad that what I'm writing is helping someone.

And I appreciate the comment on the news links.I was wondering if anyone clicked on them!

Dawn said...
This comment has been removed by a blog administrator.