Tuesday, July 2, 2013

Evaluating studies from a patient perspective

I just read a report about a study which said that major weight loss had no effect on cardiovascular disease in T2s, but of course, they should lose weight anyway. That kind of qualifier seems to be required in studies that show results contrary to received knowledge. Why couldn't they have just said weight loss had no effect on CV disease in T2s, and skipped the part about weight loss?

I think this involves assessing just what the relationship between doctor and patient should be. For example, a hypothetical patient with T2 might have metabolic syndrome adequately controlled by meds, no other comorbid conditions, and not be able to lose weight. So his CV risk factors are being controlled and there is no reason I can see to nag him to lose weight.

Another article I saw found no fault with a doctor publicly stating NJ governor Chris Christie was too morbidly obese to be president (not advocating any personal political stance here), because of his risk for CV disease. But, in fact, she knows nothing about his personal risk factors, and I think she had no business calling him out on it. Not to speak of the fact that other presidential candidates have had high-risk health problems, too.

Then there is the study in another thread about carb counting in T1s. Our overwhelming consensus on TuDiabetes (http://www.tudiabetes.org) is that it does help, even though the study concluded that there is no difference from "usual care", whatever that means.

So what is perturbing to me is that these kind of studies and opinions devalue the insights of the person into their own health status, as if we were totally unaware of our health risks and what we want to prioritize. They talk about involving patients in their own care, but then dismiss our experiences and wisdom.

I think this is a major way in which medical care needs to evolve.

1 comment:

  1. Did you read the study itself or a report on the study? Far too often I've seen a so-called science writer completely mangle what the actual study says. Half the time all the reporter seems to do is edit the press release and call it news. :-(