Research on Arthritis.

Research in the news

Reading research news critically

Today, progress is so fast in some areas of arthritis research that the media often report a new finding even before the medical journal with the study reaches your doctor's office. Often this rapid transfer of research information includes very early results that need further study before your doctor can apply them. As a consumer, you now need to know how to critically evaluate research reported in the media.

Suppose you read in a newspaper about a study reported in a medical journal that an industrial chemical helped improve skin pliability in 19 people with scleroderma, an arthritis-related disease that causes hardening and thickening of the skin. Sound promising?

The treatment described in this article was an early study on dimethyl sulfoxide (DMSO). DMSO is an industrial solvent often used as a degreaser. Early studies without control groups showed some promise. But, the Food and Drug Administration refused to approve DMSO until enough evidence on the safety and effectiveness of the drug had been gathered. Yet, media reports and enthusiastic supporters led 10 state legislatures to legalize DMSO.

Eventually, a large, randomized, controlled study in 13 clinics across the country failed to confirm that DMSO was effective in treating skin problems in scleroderma. Over one-quarter of the people treated with DMSO in the study had to discontinue the treatment because of skin blistering and peeling.

Because research results get reported in the media even before they are published in medical journals, consumers need to know how to critically evaluate claims. How can you tell if reports, such as the example on DMSO, are really promising?

Ask yourself these questions:

• Is there a scientific reason to think the results are likely?
• Are the results reported for large groups of people, a small number of people, animals, or laboratory studies?
• Were the people in the study like you? (Same age, same sex, same race, same type of arthritis?)
• Was there a control group--a group that did not receive the new treatment?
• Have the results been repeated by other researchers with similar findings?
• Has the research been published in a medical journal?
• Does the report use any qualifying words to describe the findings (such as some, may, preliminary or experimental)?
• Does the report list any questions that still must be answered before the results can be applied?
• Does the report suggest health actions that people with a specific type of arthritis should take as a result of the research?

When you read or hear about a research study in the media, it is important to know if what is being reported is (1) an early finding, (2) an unproven remedy, or (3) a confirmed result that you can use to take health actions. You can use this list to look for some of the same clues in news reports that researchers use when they review a study in a medical journal.

Evaluating new research

Researchers start with a hypothesis, a prediction based on research findings up to that date, about why something happens or fails to happen in the body or the outside environment. They look for a biological reason or explanation based on what we already know about how the body works.

For instance, some people apply industrial lubricating oil to the joints in the mistaken notion that if oil makes a machine move smoothly it will also make a joint move easily. This notion does not make biological sense because a special fluid in the joint called synovial fluid lubricates the joint, not oil. When you are reading a report about a new treatment, look to see why or how scientists think the treatment works.

Check the size of the experimental groups

Scientists will often first test a new treatment in the laboratory in test tubes. Then, they may test it in a small number of specially bred laboratory animals before trying it in a small number of people. If the results are encouraging, they will repeat the test in a large number of people. Reports of results in test tubes or animals may seem encouraging, but researchers may not be able to get the same results in people.

Reports of results in a small number of people can seem promising, only to prove faulty when tried in large numbers. For instance, in the 1980s several arthritis drugs had to be pulled off pharmacy shelves because rare but serious side effects showed up only after they were used by millions of people. When you hear about new research results, find out if the study was done in test tubes, animals, or a small or large number of people.

Look at the similarity of the groups

Researchers test new treatments on groups of people who are similar in age, sex, race, and specific type of arthritis. The reason is that if one of these factors is not the same in all groups, it could cause different results.

For instance, a treatment that works well in adults may not be safe for children with certain types of arthritis because they are still growing. If you are reading about research findings, see if the group in the study was similar in age, sex and type of arthritis to you or someone you know with arthritis.

Check whether a control group was used

Studies usually compare a new treatment with one whose effects are already known. The group that receives the new treatment is called the experimental group. The group that receives the known treatment (or sometimes no treatment) is called the control group. Neither the investigators nor the people participating in the study know who is getting the new treatment until after the study is completed. This is called a double-blind study.

Control groups and blind studies help show the results are due to the new treatment and not to some other factor. Since symptoms of arthritis can come and go, it is important to know that it was a treatment and not the disease itself that caused a change. Look for control groups in the research reports you read.

Was the study repeated?

A single study rarely gives a final result. Scientists repeat studies to be sure that the results are not due to chance or some factor other than the new treatment. That is why articles in medical journals include a review of other studies on the topic and a comparison of results.

For instance, 32 researchers in the United States and England working on four different studies tested low doses of the anti-cancer drug methotrexate in people with advanced rheumatoid arthritis. All the studies showed similar benefits as well as the risk of side effects. When you're reading a report about a study, look for references to similar findings by other researchers.

Was the study published?

Sometimes, promoters of unproven remedies will use the media, books, direct mail or other methods to bring public attention to their theories or product. Some of these reports can look like research studies.

Researchers submit their findings to medical journals that are read by experts in arthritis research and care. Before publication, experts review the methods used in the study and recommend whether the study should be published. If you read or hear about a research report, look for a reference to the journal that published it.

Are there qualifying statements?

Research studies usually end with a discussion or interpretation of the results and qualifications of their use. For instance, authors may note that this is an early finding and call for similar studies by other scientists. Look in media reports for these qualifying statements.

Are there unanswered questions?

Research studies often end with a list of questions that still need to be answered before the results can be applied to health actions. Look for mention of these questions in media reports. For instance, in a recent study of fish oils, the authors noted that the study did not answer what was the best dosage to use in order to demonstrate reduced inflammation.