You may have heard the term ‘evidence-based medicine’. This refers to practicing medicine with a solid grounding in scientific research. In medical school, we were taught how to critically appraise the evidence. Like any skill, this needs to be practiced. Hence, groups of doctors often assemble at a nice restaurant to discuss scientific journal articles. These ‘journal clubs’ promote evidence-based practice while bolstering our vibrant social lives.
Most of us, however, are not getting health information from the primary literature. The following scenario might sound familiar:
As you scroll through social media, a click-baity headline catches your attention. You take the bait and link out to an article from a media site you’ve never heard of with flashy ads all down the righthand side. You quickly skim the article or jump to the last paragraph to read its conclusion. In doing so, you’re unknowingly answering two questions:
- Can I relate to this?
- Does this support my already held beliefs about the topic?
After your brief skimming and intuition, you promptly decide if it supports or rejects your current worldview on the subject. In the former, you think ‘what an insightful piece’ (confirmation bias) and share it with your followers. In the latter, you think ‘this person has no idea what they are writing about…they are probably ignorant, stupid, or both’.
This approach, while common, is not useful. It is a product of our distracted world and results in hardening of already held beliefs. Instead, I suggest the following practical approach to assessing any health information you might be consuming, outside of the primary literature. It involves reflecting on five important questions.
Who is the source?
The source could be an individual or an organization. It’s important to find out where the information is coming from. What are the author’s credentials? Is this a researcher, journalist, news outlet, blogger (irony acknowledged), industry sponsor, etc? If you can’t figure out who the source is, consider this a red flag.
How is the source biased?
Everyone is biased. You need to figure out how, and if it could impact the presentation of their work. Be particularly cautious if the source has something to sell, benefits from a paid sponsorship, or has a track record of promoting a specific ideology.
Is the content credible?
In evidence-based medicine, we term this ‘internal validity’. This is harder to assess than the first two questions. One clue for credibility is the inclusion of references to primary literature. Even so, the author is generally betting that you won’t fact check them. If the subject is important enough, you should. Other indicators of credibility are discussion of limitations of findings or exploration of alternative views. These are necessary components of peer-reviewed scientific papers.
Beware content that makes extreme claims, using key words like ‘never’, ‘always’, ‘x causes y’, or ‘y cures z’. Good science is narrow in scope. In order to control for things, research studies have to be very specific. The result is that most evidence pushes our knowledge only incrementally. Findings usually don’t allow us to generalize to all contexts and populations, let alone make causal statements.
Does this apply to me within my context?
If you’ve made it this far, you now have to decide if the health information is actually relevant to your own situation. To do so, you need to know if the evidence upon which the source is based was generated from a population that shares your personal characteristics. These include age, sex, health status, socioeconomic status, ethnicity, geography, and more. Put simply, does the study population look like me? If not, you don’t really know if the findings apply to your situation.
How can I apply this to my current health goals?
If all of the above questions hold (they won’t 95% of the time) you finally need to determine if the new information adds value. You probably have some goals for your health and well-being. These goals, both proximal and distant, inform your strategy and behaviour. If the health information you just assessed doesn’t fit with your goals, it’s not helpful. At least not now. But there is a chance that it applies to something you are working on right now. Great, this adds value! Now you’ve got some bona fide evidence-informed data to apply. Wasn’t that easy?