jeudi 17 novembre 2016

FOR DOCTORS :BE CAREFUL OF INTERPRETING WHAT YOU READ ON LINE ABOUT MEDICAL INFORMATION

BE CAREFUL OF INTERPRETING WHAT YOU READ ON LINE ABOUT MEDICAL INFORMATION
I receive virtually hundreds of emails containing information about health, disease care, new discoveries and research.
I always remember, what my teacher Dr Howard Lessner once told me: Don’t trust information that you don’t pay for.
There are hundreds of blogs and semi-official medical journals (supported by drug companies) all appearing to present the fact, but a careful examination would reveal that they are distorting the research which had been published.
A GENERAL RULE OF THUMB: IF YOU ARE READING SOMETHING IN A TRADE OR COMMERCIAL PUBLICATION OR SITE ABOUT RESEARCH, FIND THE ORIGINAL ARTICLE AND READ IT.
I am reading an email from Endocrine Society, a professional society that I belong to and considered to be a prestigious one in the USA, and they had this item in their Newsletter.
Defining Pre-Diabetes Based On HbA1c May Predict Long-Term Diabetes Complications More Accurately Than Other Definitions Of Pre-Diabetes, Researchers Say.
MedPage Today (11/16, Kneisel) reports, “Defining pre-diabetes based on hemoglobin (Hb)A1c, an indicator of average long-term blood glucose levels, predicted long-term diabetes complications more accurately than other definitions of pre-diabetes,” researchers found after comparing “five different definitions of pre-diabetes, including two fasting glucose-based, two HbA1c-based, and one two-hour glucose-based definition accepted by the American Diabetes Association (ADA), the World Health Organization (WHO), or the International Expert Committee (IEC)
If you read this excerpt you are inclined to think that HbA1c definition of Pre-Diabetes is better method than the other five different definitions of pre-diabetes.
It was written like this and published by MEDPAGE TODAY.
If you go to their website, they write:
Content on this page was created or selected by the Everyday Health Media team and is funded by an advertising sponsor. The content conforms to Everyday Health Media’s editorial standards for accuracy, objectivity, and balance. The sponsor may select the topic but does not edit the content.
Also the “polls” they publish are not statistically valid since the method used are not scientific, but it does give them an opportunity to say, 56 % of the people polled preferred such and such a drug.
Going back to the HbA1c article, Endocrine society does give you the link to the original article, so as is my custom I checked the original article.
It was from a respectable source and an ongoing research study. Their interpretation differed much from MedPage Today:
Interpretation
Our results suggest that prediabetes definitions using HbA1c were more specific and provided modest improvements in risk discrimination for clinical complications. The definition of prediabetes using the ADA fasting glucose concentration cutoff was more sensitive overall.
Now, what do you think?
Especially if you are a health care provider?
Would you rather put your trust in a drug company sponsored publication that comes to you free of charge or read the original article and come to your own conclusion.
It is interesting to read this, just a few weeks after another research article cautioning us about using HgbA1c as a diagnostic tool for Pre Diabetes. As I work with Indigenous groups of people, we have so many sociocultural ways of defining who is at risk and plan accordingly. Japanese researchers have cautioned us: On the other hand, for the identification of prediabetes, HbA1c may be inadequate as a screening tool because of its high false-negative results.
PAY ATTENTION TO THE PATIENT AND NOT THE LABORATORY TESTS IS A WISE ADVICE TO GIVE TO THE STUDENTS AND DOCTORS.