It can be difficult to make sense of all the contradicting medical advice presented in the media. Thankfully, there are some great resources that independently review medical studies and make recommendations that doctors and patients can understand.
Choosing Wisely collects recommendations from professional medical societies in the US and gives a list of 5 things to watch out for in each specialty. This website is a very succinct place to access information for tests and treatments. Here are just a few examples:
- Most of the time, adults don’t need antibiotics for a sinus infection.
- “Most people with lower-back pain feel better in about a month whether they get an [MRI, CT scan, X-ray] or not.”
- Scheduling a baby’s delivery early for the doctor’s or mother’s convenience is usually not a good idea.
The NNT (short for “Number Needed to Treat”) categorizes medical treatments on a stoplight paradigm: Green, Yellow, or Red. Green signifies treatments that show a clear benefit, Yellow represents an “undecided” category, and Red signifies that the benefits don’t outweigh the risks. There is an another category, Black, which signifies that the risks from the treatment are greater than the benefits. The reviewed therapies cover every major medical specialty. The Green light is given to steroid use for asthma attacks, nicotine replacement therapy to stop smoking, and aspirin for cardiovascular protection, just to name a few. Showing up on the Black list are PSA (prostate-specific antigen) tests for prostate cancer screening and vitamin D to prevent fractures in the general population.
The Independent Drug Information Service takes the promotional information out of drug marketing and, as above, looks at hard data to evaluate the drugs cost effectiveness. Information is provided for providers and patients and is grounded in reality. Where applicable, lifestyle changes are suggested before taking drugs (e.g., diet and exercise changes to reduce cholesterol). Several drugs are listed for one condition, with recommendations of which drugs to try first.
The Cochrane Collaboration may be the best known independent entity reviewing medical reports. They publish the Cochrane Reviews, which take a critical look at data from many previous studies. The reviews are updated regularly and many of the reviews are available in Spanish. Generally, information provided by the Cochrane Collaboration is geared more towards health-care providers.
It is refreshing to see these independent organizations keeping medical care honest and cost effective. And most of these organizations do so without multi-million dollar budgets to compete with the pharmaceutical and medical device companies. I’d be happy to hear about other organizations that are providing similar services.