Medical research: statins, science and the media

Only 37% of the public trust evidence from medical research
While 65% trust the experiences of their friends and family

These are the headline stats from a report published today by the Academy of Medical Sciences, looking into how accurately and effectively the results of medical research are communicated with those who the research ultimately benefits — patients.

The report has made several recommendations for how researchers, medical research charities (like us), industry, universities, the NHS and the media can help patients to make informed choices about their treatment.

But why is communicating medical research so difficult? And what does the report suggest?

Scientific studies are not born equal

Not all scientific studies carry the same weight as others. It’s really important that, when we’re talking about the results of a piece of research, we make it clear just how much we can trust the results of the study, as well as what they mean.

Clinical trials called randomised control trials (RCTs) are one of the best ways to work out whether a drug is effective and what side-effects it may have.

In an RCT people are randomly assigned to two or more groups to test a drug, treatment or other intervention. One group receives the intervention being tested, the other has an alternative intervention, a dummy intervention (placebo) or no intervention at all.

In some RCTs, the researchers don’t know which group the patients have been randomly placed in, which helps to avoid any deliberate or unconscious bias.

Both groups are followed up to compare the experimental intervention with the control group. Outcomes are measured at specific times and any difference in response between the groups is assessed statistically.

In an observational study researchers observe the effect of a risk factor, diagnostic test or treatment without trying to change who is or isn’t exposed to it.

For example, a birth cohort includes all people born within a given time frame. Researchers compare what happens to members of the cohort that have been exposed to a particular variable with what happens to the other members who have not been exposed.

A third type of study brings the finding a many individual studies together, combining all the available evidence on a treatment. This is called a systematic review or meta-analysis and indicated how consistent research findings are and to what extent the findings can be applied across populations.

Choosing the right study design can make all the difference. A badly designed study can produce inaccurate or misleading results, which might still get reported in the news. This can create unjustified expectations about the effectiveness of a new treatment or falsely raise concerns about the safety of a treatment. This can result in under or over use of medication and poor outcomes for patients.

Absolute risk, relative risk — what’s the risk?

Risk is the chance of something happening. But when we see headlines like…

People who eat carrots twice a day 10x more likely to grow rabbit ears

(and yes, that’s a hypothetical example) what we need to also make sure people know is, how likely they are to end up growing rabbit ears in the first place.

This type of statistic is known as relative risk, it tells us how much more likely an outcome is in one group vs another.

Absolute risk is how likely the outcome is in the first place (so in the case of people growing rabbit ears, 0 per cent).

This distinction is important when we’re talking about medication. When deciding whether or not to take the medication offered to them, a person may have to weigh up how likely the medication is to cause other problems against them likely benefits.

A case of statins

Statins are the most commonly prescribed drug in the UK, and with over 7 million users in the UK they’re no stranger to media headlines.

Statins work by reducing a person’s risk of heart disease and stroke by stopping fatty deposits from building up inside the arteries.

A report that we funded in 2015 showed that negative news stories about statins are linked to some people discontinuing their treatment, increasing their risk of heart attacks.

Large, rigorous studies have shown that statins save thousands of lives each year in the UK and help to prevent heart attacks and strokes. So, this study emphasises why it is important that medical professionals, in particular, should be guided by the scientific evidence rather than opinion.

The public can’t be expected to keep up to date with every new piece of research so they often look to the media and organisations like us to keep informed. That is why we make sure the information we provide is based on the best science and the strongest evidence.

What does the report suggest?

There are twelve recommendations set out in the report and they demonstrate a commitment to open, transparent and collaborative efforts to ensure benefit to patient from research is optimal.

The new report urges the public and medical professionals to make better use of medical appointments, and launches a set of questions for patients to discuss with their doctor to help them make informed decisions about whether to take a medicine.

Active involvement in decision-making about their own health has been shown to improve outcomes for patients.

Some patients taking multiple medications for long-term conditions will need longer appointments with health professionals to make informed decisions.

These recommendations are about empowering patients to help them take an active part in their own healthcare. But the report also calls on a range of people and organisations involved in research to work harder to ensure that patients have access to clear and accurate information.

Patients and doctors need to be confident that recommendations about treatments are based on the best available scientific evidence. It’s equally important that the benefits and potential harms of treatments are explained to patients in a way that is simple to understand, not ‘hyped up’ and tailored to their personal circumstances.

In the end this is all about trust, in the science, scientists, the NHS and health care professionals, and the media to realise, in Dr Johnson’s phrase ‘the greatest benefit to mankind’.

At the BHF, we welcome these recommendations and remain absolutely committed to improving the information and support we provide for people living with heart and circulatory disease in the UK.

  • Jenny Mitchell is a Research Communications Officer at the BHF
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