Treatments

Medical Evidence: A Hard Pill To Swallow For Some

Marathon runners.

hide captionMarathoners are loathe to give up ibuprofen, even though scientists have questioned its benefits to them.

iStockphoto.com

If a scientist told you that the drug you're taking isn't working, and it may even be hurting you, would you give it up?

The answer is "no" for too many Americans, according to a piece published this week in the magazine Miller-McCune.

And that means, the federal government may have a hard time capitalizing on its $1.1 billion investment in research that compares treatments to one another.

For example, in 2006, researcher David Nieman found that endurance racers - a group that's collectively addicted to ibuprofen - saw no benefit from the over-the-counter pills during the 100-mile Western States Endurance Run, he presented his findings to participants in the next year's race. And, contrary to their beliefs, the anti-inflammatory drug actually increased swelling for this group, he told them. Would they stop using it? "No," was the answer.

Reporter Christie Aschwanden writes:

"As Nieman and countless other researchers have learned, new evidence often meets with dismay or even outrage when it shifts recommendations away from popular practices or debunks widely held beliefs."

What's more, some treatments and tests that are never backed up by medical evidence still find their way into convential wisdom.

Take, for instance, the findings this week of a panel convened to examine prostate cancer treatments for the federal agency that runs Medicare. The panel found "insufficient evidence across the board" to adequately weigh the risks of the latest radiation therapies, according to the group's chairman. Some panelists suggested more research to compare treatments - a la the $1.1 billion comparative effectiveness program.

Treatment aside, the medical evidence for just screening for prostate cancer has long been a matter of dispute. Back in 1999, Dartmouth researcher and physician Steve Woloshin harangued the U.S. Postal Service for a issuing a stamp that read "Prostate Cancer Awareness: Annual Checkups and Tests." Medical evidence didn't back up that call, Woloshin wrote. Many researchers still say over-zealous testing for prostate cancer leads to too-aggressive treatment that can be harmful.

There are other, more recent examples of how researchers and the public can butt heads. When the U.S. Preventive Service Task Force suggested that some women receive breast cancer screenings beginning at age 50 instead of 40, and every two years instead of annually, they drew an angry reaction. One doctor who backed the guidelines received this message: "May God help you sleep at night for the death call that you have just trumpeted!"

United States Democratic senators can be as reluctant to accept new medical evidence as the next person, despite their efforts to use research to rein in costs. The first, $940-million amendment Senate Democrats offered for health overhaul legislation requires insurers to cover mammograms for women 40 and older at little or no cost to patients, among other things. It passed 61-39.

Weaver is a reporter at Kaiser Health News, a nonprofit news service.

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