Monday, December 14, 2009

Health news that’s not: Bone drugs for breast health, feuding parents, healthcare costs

Health news is frequently driven by savvy media strategy and well crafted press releases rather than meaningful science, and this week was no exception. Here are a couple that seemed especially egregious, and a perennial that’s always irritating.

Presentations at a recent breast cancer conference suggested that taking certain bone strengthening drugs generally reserved for treating osteoporosis reduced the risk of breast cancer. One study touted a reduction in risk of 29 percent; another mentioned a similar risk reduction from approximately 4 per 1,000 to 3 per 1,000. Both were observational trials. There are at least three reasons why this shouldn’t be a news story: 1. Conference findings do not undergo peer-review, and as such have not experienced the full rigor of the scientific process. At best they are preliminary, and of interest to researchers as possible guides for future research, but no layperson should be making health decisions based on such data. 2. As observational studies, they can only suggest an association between two phenomenon, but not causation. This is an important point. For many years observational studies suggested that hormone replacement therapy reduced women’s risks of heart disease and cancer, prompting millions of women to start taking hormones. The first major controlled trials soon showed that instead of saving lives, the hormones were actually killing women at a much greater rate. Oops. 3. A reduction in risk of 20 to 30 percent sounds good, but the actual decrease in risk of about one tenth of one percent was exceedingly small.

The second study reportedly found that when parents argue in front of their children its actually healthy for the kids, so long as the fight ends with some (non violent) resolution. The rationale was given that children learn to resolve difference, and that reduced any stress they might feel, which was an overall healthy experience. In reality what the study demonstrated was that children appear to be less stressed-out when watching fictionalized arguments between actors that they were not related to, since that’s what the study actually exposed them to. That seems like a big enough difference to make the overall finding a lot less compelling.

Finally, with all the coverage of US healthcare reform, it is odd that the cost of taking care of our citizens is considered so important. The cost of waging two wars doesn’t seem to deter anyone from committing more resources to efforts in Afghanistan. The cost of subsidizing farmers to grow crops that aren’t needed and aren’t healthy doesn’t enter into agricultural policy. The cost of corporate tax breaks for activities that benefit no one but the super wealthy doesn’t alter tax policy. But the financial burden of society meeting its moral responsibility to care for its children and the ill is being cited as a reason why we shouldn’t. Fascinating.

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