Research on Arthritis.
Last updated Tuesday, January 04, 2005
Research in the newsReading 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.
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