Science by its very definition must be meticulous, precise and truthful. There was a time when new discoveries could be expected by the decade or possibly yearly, a virtual trickle of worthwhile results. Today it seems we are bombarded hourly with a plethora of claims for new cancer treatments, breakthrough advances in our knowledge of every aspect of human physiology, claims for good foods vs the bad. There is no doubt Marshall McLuhan’s information highway has evolved to the status of an interstate but is there really that much more truth out there?
The answer lies in the process that occurs between the doctor (PhD or Md) actually pondering the research findings and the spin doctors competing in the market place for “audience share” presenting the information to a knowledge thirsting public. So what are the clues allowing us to separate the fact from this presentation hype?
Research can be broadly subdivided in to three categories. The first of these is the retrospective demographic analysis. The classic and most acknowledged version of these is the Framingham heart study. The basics involve analysis of health data from a substantial poulation base. A rough guideline is any time you analyze management outcomes in a substantial population (read over 100,000) with similar socioeconomic status, you are very likely to have valuable information on which to evolve future study models. The key to this type of research is clearly the size of the group studied and the location. A bad example of this technique is a recent Scandinavian country study declaring “white fruits” healthier than coloured fruits on the basis of a phone survey of ten thousand people asking their recollections of food type ingestions over the past ten years. Do YOU remember what you ate last month?
The second type of research is referred to as clinical trials. These occur when Federal regulators approve human trials in small populations on the basis of previously favorable laboratory and animal studies by pharmaceutical companies.There are several weaknesses in this process. The sample size is often quite small and the nastier downsides we call side effects are often delayed till many months of usage of the new drug. A recent example of this occurred with the Cox 2 inhibitors vetted to be the wonder cure for any number of arthritic ailments until major cardiac complications including sudden death began after more than six month of usage. The drug developers are caught between a rock and a harder place on this one. Their claims it costs $600 million to bring a new drug to market are only half truths. $300 million is legitimate science investment and adherence to regulatory requirements but the operant word for the other 300 million is “market” selling the product to a public with too many options already on the shelf.
The third category of research occurs in the laboratory in petrie dishes or on animal models most of which are rats or mice, creatures unlikely to raise the ire of animal protection groups.
These mice are specially bred strictly for research purposes. They contain a genetic mutation that causes them to have underachieving thymus glands; hence, deficient immune systems. These mice are injected with cancer cells which do not trigger the standard immune response. Various treatment options are then introduced and can be studied for efficacy in a relatively uncomplicated tissue environment. The “nude” bit comes from a genetic aside that they coincidentally have no body hair.
Remember the trumpeted claims blueberries prevent breast cancer? Or the heralded proclamations pears prevent strokes?
Back to my nude mice for the answer. After being injected with cancer cells, the mice were subjected to various dietary and chemical regimes to test the impact on the growth rate of the cancer cells. The blueberries were the winner with a 12% reduction in the growth of a specific type of aggressive breast cancer responsible for 15% of human tumors. The problems with this type of research are twofold. Nobody has ever proven there is a direct extrapolation between cancer behaviour in mice and the human body. The mice are merely a controllable study venue. The other issue is weight equivalency. We humans would have to consume the equivalent of two 8 ozs cups of blueberries every day of our life for the potential but unproven benefit of a 12% risk reduction in this one type of cancer.
A senior editor taught me a good report includes all the elements of who, what, where, why and when. Health consumers today would be wise to follow similar guidelines to avoid the hype.
Next time you read a science report, put it in perspective with the following questions. Am I getting this information from a recognized science journal where peer review occurs or is it spewing from a six o’clock news fifteen second sound bite? Also, is this a laboratory finding before human clinical trials which means a likely decade gap till available in your pharmacy?
Written by: David Carll MD Retired family physician.