12.18.2014

--Courtesty of Gizmodo-- "Study: Dr. Oz is full of shit" [i am jack's complete lack of surprise]

Ok, just to reference the first bit of that*:

But about Dr. Oz... [it also involves another show, but I often pick on Dr. Oz more. Yup.]

The issue is REALLY about medical media, specifically talk shows in this case. Should the recommendations they make be considered professional, safe, evidence-based?  I honestly think that if you have a degree and are making recommendations in any form within that field under the acknowledgement that you do in fact have training and education in that field, you should be held to professional standards. I personally understand though, that money is a strong motivator, and I kind of don't trust anyone at this point without personally learning about the cost/benefit ratio and getting a larger picture of information.

I would wish that everyone could and would do that. 
It is not a reasonable expectation however, and I get that. First- I don't have a busy life. Let's be honest about that. I don't have a lot going on. I can take hours to research specific medications, treatments, the evidence for or against a certain protocol. 

I also have a lot of background in health, biology, neurology, pharmacology, psychology etc etc etc. A lot of this is from a formal educational background. Some of it is from applying that formal education to my own life- learning as I have gone through the health system. In doing research as well, I have a basic understanding of how to read an article from pubmed or similar.

That doesn't mean I'm smarter- I simply have a different background [and, to be clear- I'm always still learning about all that]. I am not going to expect someone with a background in accounting to necessarily have as strong an understanding of a PI sheet, but I'm not going to be #supergreat at running taxes for pretty much anyone but me [and some years that gets complicated, honestly].

There is also this implicit and sometimes explicit "understanding" in the doctor/patient relationship: the doctor is omniscient and the patient is completely ignorant. While that's really a bunch of bullshit in the black and white sense that it is supposed to be embraced, it is so deeply embedded in the western idea of medicine that it is very hard to break out of. Particularly for any demographic that could be considered vulnerable in any sense. If you are sick, you are already down a peg.

And... I mean pretty much if you lack a grad degree and then beyond that if you are not male and white and between like, 25 [maybe 30] and 50 years of age- you are often assumed to have no idea about anything.

So all of these factors mean: when someone like Dr. Oz, or the experts who are on the show The Doctors present information, and they are degree'd professionals? People will more often than not just listen instead of look elsewhere for more information or opinions.
---
From the BMJ study:
[PRINCIPAL FINDINGS]

The Dr Oz Show and half of the recommendations on The Doctors were based on believable or somewhat believable evidence. Evidence was believable or somewhat believable against a recommendation for 1 in 8-10 recommendations. For slightly over 1 in 3 and 1 in 4 of the recommendations for The Dr Oz Show and The Doctors respectively, no evidence could be found. This is despite us being quite liberal in the type and amount of evidence we required. The percentage of medical practice in the real world that is evidence based is difficult to ascertain, although one review reported an average of 78% of medical interventions were based on some form of “compelling” evidence. Comparisons are difficult, however, because the types of evidence that was required to determine this is considerably varied.


When the shows offered recommendations:
  • less than 20% of the time did they actually specify how beneficial the recommendation was likely to be. If it was a weight loss recommendation, there was no specification regarding how much weight. If it was supposed to have a cognitive benefit, no specific numbers or quantifiable information regarding what one could expect.
  • less than 15% of the time was it mentioned how much something might cost. Many of the recommendations on these shows which are related to weight loss are not regarding exercise... i have noticed that a lot of them are regarding supplements/vitamins/herbs which can be kind of pricey. If someone is hooked on something they believe will work before they know the price, they are much more likely to buy it
  • less than 10% of the time were harmful potential side effects mentioned. So more than 90% of the time these experts simply neglected to mention side effects which were known to have occurred in relation to their recommendation. 


For the 160 recommendations that were randomized for evidence review, The Dr Oz Show recommended consulting a healthcare professional 9% (7/80) of the time compared with 33% (26/80) of the time on The Doctors.

So for example, on the Dr. Oz show 9 out of 10 recommendations were made with no explicit information regarding the possible harmful effects. Less than 1 out of those ten times was it recommended that someone seek further information or guidance from a healthcare professional.

This is a problem.

Televised medical talk shows—what they recommend and the evidence to support their recommendations: a prospective observational study

BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g7346 (Published 17 December 2014)

Korownyk Christina, Kolber Michael R, McCormackJames, Lam Vanessa, Overbo Kate, Cotton Candraet al. Televised medical talk shows—what they recommend and the evidence to support their recommendations: a prospective observational study BMJ 2014; 349:g7346

*provided by Kinja

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