An expert gives tips for interpreting medical advice
Health information and medical news can seem as confusing as it is helpful — especially when it appears contradictory.
Should we forego alcoholic beverages because of their health risks or occasionally indulge in an antioxidant-rich glass of red wine? Should women start having annual mammograms at age 40, as the American Cancer Society suggests, or age 50, as the federal government advises? Should we ever change our habits based on the latest research?
Q: What's the best way to react to news about a particular treatment or medication?
Earvolino: Call and talk to your doctor or set up a visit to discuss your concerns. Generally these conversations are more meaningful face-to-face, but even if you can't come in or you've just been to the doctor and don't want to go right back, make sure to call.
Don't make changes — like stopping medications, for example — without discussing it with your physician first because there might be a very good reason why you need to keep doing what you're doing.
For broader issues like diet or lifestyle choices, if you see an article you have questions about, I would encourage you to hold onto it and bring it with you to a preventive visit with your physician, where it's appropriate to talk about those types of questions.
Q: Aside from discussing it with a physician, how can you determine whether health information is reliable?
Earvolino: You always have to be careful to make sure that you're not reading something that's biased by someone who stands to make money from it. If information comes from a pharmaceutical company that's promoting a particular medication, for example, you have to be careful.
For general broad topics, government Web sites such as the Centers for Disease Control and Prevention's tend to be reliable, as do Web sites of the major nonprofit associations and physician organizations, such as the American Medical Association and the American College of Physicians, that don't have a tie to one particular therapy.
Especially in circumstances where there are conflicting recommendations, it's very important to have a good primary care doctor with whom you can decide what makes the most sense for you.
Q: What about when reliable sources contradict each other? For example, the American Cancer Society has different recommendations than the federal government about how frequently women should be screened for breast cancer.
Earvolino: Especially in circumstances where there are conflicting recommendations, it's very important that you have a good primary care doctor with whom you can discuss the various recommendations and decide what makes the most sense for you.
Many recommendations are based on large studies designed to determine how many patients need to be treated to make a particular intervention statistically worth doing from a variety of perspectives — cost, number of positive outcomes, etc. But because everyone has different risk factors, different family histories and different overall health, you really have to take each case individually.
For example, many recommendations against doing routine testing are based on the potential for false positives to have a negative effect, statistically, on the population as a whole. But on the individual level you have to consider how the patient might be personally affected by a false positive versus not screening.
There's not always a clear right answer, so these kinds of decisions really need to come from a good conversation between doctor and patient.