Evidence-Based Medicine in the Age of COVID

August 24, 2020 Joe Brady

Health Care is not an industry! We all have an interest in staying healthy and that depends upon being able to tell good information from bad. Since the earliest days in the history of medicine, health professionals have long fought to dispel myths and counter misinformation. During the current pandemic and unfettered reach of social media platforms, health misinformation has become a viral pandemic of its own. A report released this week estimates that social media networks amplifying misleading health information generated an astonishing 3.8 billion Facebook views in the past year alone. “The only cure for ignorance is education”, the ability to sort through all of the misinformation in health care is an essential skill in life these days. We need to be able to determine good sources of information from bad sources, to be able to see for ourselves what is good science and what is not.

Everyone needs health information and also needs health literacy skills to find information and services they need and understand the choices, consequences, and context of the health information they receive so they can decide which information and services match their needs and preferences so they can act. Anyone who provides health information and services to others, such as a doctor, nurse, dentist, pharmacist, even their exercise instructor, acupuncturist, or Yoga teacher, also needs health literacy skills. Everyone involved in health care should be advocation for evidence-based medicine, and to be able to judge for themselves the strength of the evidence.

Read more for the basics of evidence-based medicine, the top ten list to spot BS (bad science), and where to find good sources of information. 

Evidence-based medicine

Evidence-based medicine (EBM) means using the best available scientific information to guide decision-making about health care issues. 

Evidence-based medicine includes three key components 

  1. research-based evidence, 
  2. clinical expertise (i.e., the clinician’s accumulated experience, knowledge, and clinical skills),
  3. The patient’s values and preferences.

Research-based medicine is actually a hierarchy. Starting with low-quality research like background research, expert opinions, and the World health organization would include historical evidence, if ginger has been used to settle stomach upset for thousands of years that is at least some evidence of its safety and efficacy but obviously a long way from being proven. Next, come experimental models with animal studies. Time-series studies are increasingly effective with modern advances in information technology, observational studies in real-world settings are becoming increasingly useful for studying things that don’t work as well in a laboratory setting like human behavior change. The gold standard in evidence-based medicine is the systematic review of randomized controlled trials, where multiple studies are compared for reproducibility in randomly chosen subjects.

https://www.healthcatalyst.com/5-reasons-practice-evidence-based-medicine-is-hot-topic

Get the latest research on COVID-19

The Centre for Evidence-Based Medicine develops, promotes, and disseminates better evidence for healthcare.

Oxford COVID-19 Evidence Service

Rapid evidence reviews, data analysis, and thought-provoking writing relating to the coronavirus pandemic, updated regularly.

The Centre for Evidence-Based Medicine thanks its major benefactors Maria and David Willetts for their generosity and support for the Oxford COVID-19 Evidence Service.

Top 10 Ways to Spot BS – Bad Science

From an article by Becca Smithers see below to read the original

Bad science is where people misuse science and scientific research, usually to get you to buy something, to change your mind, or to make something seem better than it actually is.

1) Unrealistic claims If it sounds too good to be true it usually is.

2) Small sample sizes The larger to study is the more likely the results are to be accurate.

3) Correlation and causation confusion! 100 % of fires have a fire truck present, this does not mean that fire trucks cause fires!

4) Use of over-complicated (or even made up!) scientific language Terms like “cellular rejuvenation”, “polypeptide” and “micro-exfoliating”, sound really scientific and yet are actually meaningless.

5) Where does the research come from? Beware of research funded by folks who may profit from their findings. This applies to even the most prestigious research organizations.

6) Non-committal language Non-committal language indicates that you can’t really trust the product to do what is being advertised..

7) “Scientifically proven” Science doesn’t prove things. It gains evidence towards a hypothesis

8) No control group Check to see if there is a control group or at least a comparison group. This helps to check the science.

9) Non-replicable results This requires a bit of research on your part. If you have managed to find the original study, look at what other papers and research is referred to and see if you can find these journals as well. 

10) Can you find the research it refers to? If an advert or a campaign refers to some research or claims some statistics, they must have got them from somewhere. 

The number one rule to finding bad science: question everything!

https://www.newsweek.com/doctors-fight-covid-19-misinformation-facebook-letting-it-go-viral-opinion-1526826

In Colorado NEW COVID-19 DATA TOOLS

Governor Polis was joined by State Epidemiologist, Dr. Rachel Herlihy with the Department of Public Health and Environment, to unveil the state’s new enhanced online data tool. This website includes changes and improvements to data sharing on the state’s COVID-19 website.

Having the latest data is critical to our response to COVID-19 and the state wants to share that information with Coloradans with our new easier-to-use website, so that everyone can make smart decisions. 

CDPHE’s new tool doubles down on the state’s commitment to transparency and empowering the public and our partners through access to accurate, up-to-date COVID-19 data and information. Colorado’s COVID-19 public data set is among the most robust, user-friendly, and transparent in the country.

Since the first positive test was confirmed in March, the agency has vastly increased the quantity and complexity of data that we are sharing with the public, and the data team has worked very hard to roll out this exciting improvement.

Get the latest numbers straight from the horses mouth 

https://covid19.colorado.gov/data

How Can Organizations, Communities, and People Improve Health Literacy?

The resources on this site will help you learn about health literacy and what you, your organization or community can do to improve it. The goals and strategies in the National Action Plan to Improve Health Literacy a good place to begin. You can sign up for the Institute of Healthcare Advancement’s health literacy listserv  and keep track of new developments in the field.

We all have a part to play

Businesses, educators, community leaders, government agencies, health insurers, healthcare providers, the media, and many other organizations and people all have a part to play in improving health literacy in our society.