Caution! Always View Clinical Trials with a Healthy Dose of Skepticism

We are barraged by data. In medicine this comes in the form of clinical trials and reviews. In everyday life data from news outlets strike us at every turn. We also have the internet and TV talk shows. Everyone seems to have an opinion about everything. So how do we separate the wheat from the chaff? When it comes to science, this is what I advise.

First, understand that science is not static; it is a process. It is also not black and white; it comes in countless shades of grey. Published studies are attempts to find biologic connections. They are single links in the chain of understanding. They do not stand alone; they always must be viewed in the context of all other clinical trials as well as our understanding of the complexity of human biology. Never though do we gain a hotline to god. Never are we able to say, “this is truth and all else fiction” after the publication of a clinical trial. So if you hear or see someone go to a place of certainty on the basis of a single trial, be very, very skeptical. Even if that individual is a so-called expert. The experts are not gods.

Second, there are levels of importance among the trials; some therefore are “better” than others. Rarely do you hear even the experts on TV speak about this. They typically speak only about the “abstract”, a brief summation at the beginning of every study. This is an area too complex for most clinicians to fully grasp. How then can we expect the lay population to comprehend this nuance?

Third, and probably most important of all, every trial comes with flaws. Sometimes these imperfections entirely devalue the trial’s results; other times they simply raise cause for concern. Regardless, to do a trial justice, one must read it with a fine tooth comb. In fact, when I really need to understand a particular study I spend four or five hours reading and critiquing it. Imagine that; four or five hours for a single trial. How then can I treat patients, teach, write, and still have time to read the many thousands of trials published annually. I can’t.

In sum, be cautious. Do not jump to conclusions when a study is published. Do not panic. Do not stop your medications or supplements until you’ve had the opportunity to discuss the findings thoroughly with your doctor. Always be circumspect and vigilant when learning about a clinical trial. Always maintain a very healthy skepticism. I guess in the final analysis the truth is that you can’t always believe what you read or hear. Competing interests often get in the way of truth. And the truth with clinical trials is that they are not at all about “the truth”. They are simply small cogs in the wheels of discovery.

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