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In this podcast episode, consumers learn how to be their own best medical expert for important decisions regarding their healthcare. With so much contradictory health information readily available via the internet, understanding how to be your own best medical expert can be challenging. Facts based in good science can be hard to identify.
In addition, facts take time and effort to establish. A new airborne contagious virus pandemic will not have adequate studies about specifics until time has passed and the event unfolds. But, researching information of airborne viral disease events of the past for comparison is possible. Also finding good science data on the use of protections, such as mask wearing to avoid disease spread, can be done.
The key to web research is to remember that anyone can put up a website and promote their version of science “facts.”The idea that “good information based on accurate science” will rise to the top of your web search is not a given anymore. Knowledge is in an age of paradox. While vast amounts of information are more readily available than ever before, it takes close scrutiny to sort out fact from fiction.
How can healthcare consumers better discover accurate answers?
First, understand the difference between anecdotal information and scientific statistical analysis of group data.
What is anecdotal evidence?
An anecdote is a story. In medicine, it is what we share about a medical experience we have had or someone else has had. We share it and often believe it is “evidence” that proves a course of action is correct. As humans, we are predisposed to like anecdotes, because we can relate better to stories. Scientific evidence is hard to grasp.
What is scientific evidence?
Scientific evidence today lies most often within the scope of statistics. Statistics is also a science, and it deals with collecting, organizing, analyzing, and drawing conclusions from sampled data to the whole population.
A proper medical test study design will have an appropriate selection of study samples. Also there will be a double blind component which means information which may influence the participants of the experiment is withheld (masked or blinded) until after the experiment is complete. Good blinding can reduce or eliminate experimental biases that might come from a participants’ expectations. Other bias possibilities that need to be eliminated in the study would be any effect on the participants caused by the observer’s study of them, observer bias, confirmation bias, and other sources of bias. Peer review is also part of a good scientific study.
Decades ago, scientists didn’t conduct randomized controlled trials. They based their data and treatment on case series and anecdotal evidence. (Anyone ever hear of heroin being used as a cough suppressant for children in the early 1900s?)
Medical recommendations for treatments from physicians today are most often based in studies with statistical analysis of large groups of data. Do we really want to go backwards and use anecdotal evidence as the mainstream basis for treatment again?
Ask yourself this question when looking at medical information.
Is this source of healthcare information rooted in anecdotal evidence or based in evidence from a structured study that used the scientific method to determine results and eliminate bias?
A second major concern when examining healthcare and medical expertise is “conformation bias.“
Bias can occur not just in the study itself but also in ourselves. The fact is we all like to see our conclusions confirmed. We seek the answers we want to hear. We are all subject to the weakness of confirmation bias when we research answers. Being aware of this at the start will help steer us away from less authentic answers.
Ask yourself this question when looking at medical information.
What possible confirmation bias do I hold onto when I research this healthcare subject?
A third major concern is becoming overconfident in your learning. Psychologists call it the Dunning Kruger effect.
The Dunning Kruger effect is the name given by psychologists David Dunning and Justin Kruger in 1999, to describe an aspect of confirmation bias. It’s the part where we become over confident and over estimate what we have learned about a subject. In our overconfidence, we become blind to what we really don’t know. When asked to rank their knowledge on a subject, experts tend to rank themselves less knowledgeable due to the fact that the more they have studied their field the more they realize that there is a lot more to know on the topic than what appears at first glance. Whereas the ones who actually are not experts will believe and measure themselves as more expert because they tend to overestimate what they know.
Its why an expert golfer might actually rank themselves lower than a good, but non-expert, and overly confident golfer. It’s too hard to accurately estimate what we don’t know.
The Dunning Kruger affect applies to all of us. Self-knowledge of this confidence bias tendency is an important factor in an honest research process.
Ask yourself this question when looking at medical information.
How can I avoid the Dunning Kruger effect in my efforts as I research healthcare and become my own best medical expert?
For more examples and discussion on good research strategies for healthcare consumers, listen to our podcast, MD Talk: Healthcare? How To Be Your Own best Medical Expert.
Show notes:
2:00 Puzzle of the roast and the dinner party
3:30 How does personal experience factor into seeking the truth of a medical subject?
5:00 Anecdotal versus statistical analysis in regards to recommended treatment decisions
7:30 Observations drive our actions to survive
10:00 What is confirmation bias and why does it matter?
13:30 What is Dunning Kruger effect and why does it matter?
20:00 How do I search for relevant healthcare information
25:00 How is data manipulated to confirm a desired outcome?
How can I weed out “bad” study data? (See “Spotting Bad Science” poster below)
- Is the headline sensationalized?
- Are the results misinterpreted for the sake of a good story? (Read the original research)
- Is something being sold for financial gain?
- Is the correlation and causation clear or confused?
- What conclusions are supported by the evidence or is there speculative statements?
- Do the sample sizes appear adequate or quite small?
- How are the sample sizes representative of the larger population? (They should be.)
- Are sample groups randomly assigned, and is there a control group?
- Is there blind testing when applicable? This is where researcher and participants are not in “the know” as to whether they are in the actual test group or in the placebo group.
- Does the researcher report the data selectively, i.e. “cherry pick,” or are they forthright about all results?
- Can the results be replicated? If so, that is a good thing. Extraordinary claims require extraordinary evidence.
- Have other scientists had opportunity to appraise and critique the study? (peer review)
25:00-36:00
How do I find trusted resources?
Why trust an expert over a highly vocal dissenter?
How can I remove my emotion from my pursuit of truth as I research?
Isn’t truth relative? In science, what is the difference between absolute truth and perspective based truth?
Why do medical professionals usually not post information on social media regarding “controversial” issues, medical or otherwise?
40:00 Testimony of faith
Answer of the puzzle of the roast and the dinner party
Healthcare topics? Here are some resources.
Uptodate: they have an incredible wealth of patient knowledge and information it just isn’t always easy to find exactly what you are looking for but it is probably the most vetted medical information available
https://www.uptodate.com/home/uptodate-subscription-options-patients
Google Scholar: A general scientific search forum that combines an extensive group of scholarly search engines into one platform. Best for more scientific references. Remember to look for the abstracts if available.
WebMD: patient oriented medical information but limited in scope.
Mayo Clinic Patient Topics: good general patient information.
https://www.mayoclinic.org/patient-care-and-health-information
AAFP Patient Handouts: educational handouts.
https://www.aafp.org/afp/handouts/viewAll.htm
Dunning Kruger effect
A psychological impact. We all have a tendency for it. https://www.psychologytoday.com/us/basics/dunning-kruger-effect
In life. “The fool doth think he is wise, but the wise man knows himself to be a fool,” wrote Shakespeare in As You Like It. Little did he know, but this line perfectly encapsulates the spirit of the Dunning-Kruger effect.” https://www.zmescience.com/science/the-dunning-kruger-effect-feature/
Rough Guide to Spotting Bad Science Poster
Facebook post about this “spotting bad science “poster https://www.facebook.com/FlinnScientific/photos/a.331994060213678/1679041635508907/?type=3&theater
Facebook page that featured this poster https://www.facebook.com/FlinnScientific/
