Wednesday, February 20, 2013

The use of the words "can" and "may"


Epidemiologic studies cannot always prove cause and effect.

One clinical study does not make the golden rule. It may prove a hypothesis but should the experiment should be repeatable, given the same settings.

With these two important research concepts, the public is advised to make sure that what he/she reads is thoroughly discerned. With technology at our fingertips, and an abundance of bloggers who blog for a living, I caution the public on information they capture and read on-line, especially within the realm of medical science. Medicine is NOT an exact science.

I blog about fellow bloggers who have no authority to write about a field they are unfamiliar or not professionally trained to provide an opinion about. This causes undue harm by providing wrongful "dis-information" to the public. To cite a clear example is a mom blog site where she promotes the use of a probiotic in order to increase platelet count in patients with dengue infection.

It is a fact that if patients are faced with a disease that has NO treatment, we will draw at straws in search of a cure. And while there is nothing wrong looking for a cure - desperate circumstances result in desperate measures. But desperation can be fatal for those who don't understand the science and just read the results.

The use of the words "can" and "may" should be the benchmarks for any claims made from researches or clinical trials.

An example is the current American Academy of Pediatrics Guidelines on Pesticides and Kids. While there are data on acute and chronic exposures to pesticides, the technical data report discusses ASSOCIATIONS, which does not mean cause and effect. There is an increasing amount of data in the literature linking chronic exposure of children to pesticides with neurodevelopmental problems or some form of cancer later on, but the literature provides data on the LINK and does not explicitly state a 100% cause and effect scenario. Cancer or neurodevelopmental disorders may emanate from other causes and not necessarily the pesticide exposure. While undue exposure to pesticides CAN increase the risk of chronic diseases in pediatrics, the amount of pesticide exposure or duration of pesticide exposure MAY be a contributing factor. The statement being made is to diminish the primary exposure through preventive measures (by providing less exposure to pesticides) so that we CAN minimize long-term problems.

Saying that taking probiotics CAN bring up the platelet count of patients in a study that is highly flawed is like putting the carriage in front of the horse. I don't know how much the mom blogger got paid for saying this, but it is highly controversial and highly unethical for a non-professional to endorse a product's clinical trial that has no foundation except that it was written (but not PUBLISHED) by three doctors.

At any rate, the internet is currently full of trash and the public has to be warned about all the information flying around. Only a handful are truly informative. Having to sift through which ones are useful MAY be the challenge here.

Remember, media will always attempt to appeal to the emotion rather than what is essentially true. Capturing what they want in 60 seconds or less is appealing to the attention-deficient audience they have.

But here's the take home message: THERE IS NO GREATER FOOL THAN THE FOOL THAT IS FOOLED BY A FOOL.

A friendly tip - if you want to make money with a blog site, don't do it at the expense of the public's health. Just go put up a porn site.



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