Understanding research articles
How to know what to believe when reading about breast cancer research
Filtering out what to believe when reading about breast cancer research can be overwhelming to someone who has been diagnosed with breast cancer, or for those helping a loved one navigate the maze of information surrounding this disease.
Conflicting messages, oversimplification of complex studies and just plain misinformation about causes, treatment, scientific breakthroughs and miracle medicines can be found far and wide.
Every day there are new seemingly crazy headlines about breakthroughs – carrots reducing breast cancer risk, a virus found in cattle linked to increased breast cancer risk, the ‘Angelina effect’ increasing double mastectomies – so it’s important to be able to distinguish reliable information from sensationalised headlines.
The National Breast Cancer Foundation reports regularly on the results of breast cancer research studies that either we have funded or believe are important advances in prevention, diagnosis, treatment or for the quality of life for survivors.
We’ve put together some tips to help you cut through the clutter of information around breast cancer research so you are more able to determine what is true, what has been hyped and what is misleading.
What should I look for in a news story about a research study?
Your introduction to a research study will likely come from a headline, a newspaper article or a story you see on the evening news. Or you will find various blogs and other sources of information on the web. Many of these are summaries of the latest in health care research and can sound dire or too good to be true. The truth usually lies somewhere in between.
Think about these questions when considering whether the article or research study has merit: Does the article cite a journal where the study was published or where the data came from? Does it tell you how many people were involved in the study? Does the article exaggerate the condition? Over-sell symptoms as diseases themselves? Does the article include the cost of a new intervention? Cite the harms of the intervention? Include perspectives from the other side? Give a timeline for any patient benefits?
Critically reading a news account or blog of a health care “breakthrough,” “warning” or other research-related finding is an important first step. And remember, sometimes you are reading objective reporting and other times a subjective analysis or first person account and it’s important to know the difference.
Who is the expert?
It depends. It’s important to understand who is giving the information you are considering. A medical doctor, even a breast cancer specialist, is not necessarily an expert in conducting research or in analysing it.
Looking at the news coverage of the various mammography screening guidelines is helpful to understanding how to answer this question. Mammography screening is a screening tool for a healthy population – most women get mammograms at some point in their lives.
Medical interventions, including mammograms, are based on scientific evidence. The strongest evidence about any intervention or procedure comes from randomised clinical trials. You might assume that an “expert” when it comes to mammograms is a radiologist because she or he is the doctor who reads your mammogram results. But your radiologist is most likely just an expert in evaluating the result of an individual mammogram.
The experts in determining population-based public health interventions such as how often and at what age women should get mammograms are the public health scientists and doctors who design and analyse all the evidence about mammograms to determine if they help prevent breast cancer deaths. They then set guidelines based on that evidence.
The process and type of experts involved in determining if a new treatment is effective may be different. And sometimes there are conflicts of interest that should make you question the messaging. Is the information coming from an objective expert, or is it from a medical expert or group with a subjective stake in the matter?
Remember, not every doctor is necessarily an expert in every aspect of breast cancer.
What is a good study?
When you read about a new, “scientific” study telling us that X, Y, or Z increases our cancer risk or helps prevent us from contracting a certain disease or is a breakthrough treatment, it is important to ask questions and seek more information before assuming it is true.
Is the study a human trial or animal study? Most preliminary or basic research studies are conducted using animal models. These are important basic science studies to complete, but the results may not translate into humans. Until human clinical trials are actually performed, animal studies remain preliminary reports of what might one day impact humans. It has been said many times that we often cure cancer in mice. But that cure has yet to translate to a human being.
What type of study is it?
There are many forms of human studies with varying degrees of reliability. Breast cancer is not one disease, it’s actually many different sub-types of cancer, so anecdotes, of what happened to one or a few people are not reliable, because they are biased observations which cannot then be generalised to others.
A case report documents an unusual case or outcome from treatment – but again, the results although interesting for personalised treatment insights could potentially not apply to others.
An observational trial looks backwards to study a treatment or forward to observe who gets a disease or condition – this is better but, for example, you cannot control all the factors that could contribute to the development of disease so it’s hard to extrapolate usefully applicable information.
Randomised clinical trials are the gold standard for testing a new drug or intervention. Because people are randomly assigned to experimental groups or a standard of care group, and most of the bias is controlled, we are more comfortable saying the results are true and applying them to others like those in the study.
So who – and what – should you believe?
There are no easy answers, and it can be tempting to bias your own reading towards finding the answers that you want, regardless of how unreliable the source.
The bottom line is that scientific studies are complicated. Be willing to ask critical questions, and/or only seek information from credible news sites, peer reviewed scientific journals (which often have lay descriptions) and official bodies or associations that specialise in breast cancer research to ensure you get reliable information.