How to Interpret Risks and Benefits When Reading Health Studies
I could probably live to age 120 or so. Or at least I should, if the reports of many, many health studies could be taken at face value.
These reports usually state that if I continually do X, Y and Z (each of which is said to extend survival by maybe 20 percent) and take meds A, B and C (which extend it by another 20 percent each), then I’m golden for decades to come.
And if only I drank coffee, I could probably live even longer. You may recall the recent publicity showing a connection between drinking coffee (though not too much, mind you) and longevity.
Does Drinking Alcohol Add to Longevity, too?
My latest favorite study states that drinking alcohol (and that includes spirits, wine and beer) three or four days a week could mean a lower risk of developing diabetes. Danish researchers found that men who drink frequently had a 27 percent lower risk, while the statistic was 32 percent for women.
Sounds great, right? But you know the adage, ‘if it’s too good to be true, it probably is’? One question to consider is, 15 percent lower risk compared to what? 27 percent or 32 percent lower risk compared to what?
Let’s say that as an individual you are at a low risk for developing diabetes. How much of a difference does that 27 percent or 32 percent make?
That’s something to keep in mind not only for the next time you read about the benefits of any treatment, medication or habit change.
Once you understand those numbers you would know how they pertain to you the next time your doctor talks about the risks and benefits of proposed treatments, medications or habit changes he or she has in mind for you.
A Different Way to Visualize Risks and Benefits
All of this may be complex and difficult to assess for yourself as an individual. Instead, a good strategy is to imagine a 1,000-seat theater. That’s what Erik Rifkin, PhD, and Edward J. Bouwer, PhD, did in a book about health benefits and risks they published in 2007. They called this association the Benefit-Risk Characterization Theater.
The Theater association is also used to illustrate the risks and benefits of a variety of illnesses and conditions on Dr. Andy Lazris’ and Rifkin’s website.
Let’s take mammograms as an example. It’s certainly an article of faith among many of my peers, and probably yours too, that the annual mammogram is a good idea. Medicare and insurance companies like it, too.
But how many lives does this procedure save? Conventional wisdom is that mammograms cut the risk of dying from breast cancer by as much as 20 percent. (Woo-hoo, on our way to age 120!)
Now imagine that 1,000-seat theater filled to capacity with women who have all had regular mammograms. According to Lazris and Rifkin, four
out of those 1,000 will eventually die of breast cancer anyway.
Understanding That 20 Percent Difference
Imagine again that theater filled with 1,000 women who do not get mammograms. Five of those 1,000 will die of breast cancer. That’s the 20 percent difference. Moreover, that 20 percent does not address your individual circumstances or your risk profile, or how likely you’d be to die of breast cancer.
The Benefit-Risk Characterization Theater also shows that 64 women will get biopsies for false positives, while 10 will get unnecessary surgery or radiation for lumps that would not have become problematic.
This may sound simplistic, but it can certainly set the stage for a different kind of conversation with your physician. It could also give you a different perspective the next time you read about treatments, medications or activities that boost your likelihood of reaching old age in good health.
As a newly-minted Consumer Reports Choosing Wisely Patient Champion Activist, I would be remiss if I didn’t mention that the magazine’s Choosing Wisely Campaign offers encyclopedic information about questions to ask and issues to consider about a wide variety of medications, treatments and procedures. Those range from antibiotics, medical tests, opioids, screening tests, Type 2 diabetes drugs and much more.
So, raise your glass of wine, or your cup of coffee – in moderation, of course – to learning more about the proper way to consider the risks and benefits and become a better advocate for your health or the health of people you love.
Did you ever change your eating or drinking habits based on reading about their effects on your health and longevity? Have you ever asked your physician about whether the possible risks, or harms, of a medication, treatment or procedure outweighed the benefits? Please join the conversation.
Editor’s note: Nothing in this article is medical advice. Please consult your doctor before making any medical plans.
A journalist for more than 40 years, Ellen Rand is a hospice volunteer and author of Last Comforts: Notes from the Forefront of Late Life Care. Inveterate optimist, aging baby boomer and besotted grandmother, she is passionate about sharing news and guidance about finding excellent care for ourselves and our loved ones. You can visit her blog here and follow Ellen on Twitter.