Medicina Baseada em Evidências

Improvements in abstracts and plain language summaries needed

Maryann Napoli, Associate Director of the Center for Medical Consumers (New York City), is a member of CCNet’s Geographic Advisory Group as well as the US Cochrane Center’s consumer coalition, Consumers United for Evidence-Based Healthcare. A regular Cochrane contributor, she reflects on an opportunity for growth within The Collaboration’s plain language summaries.

Cross-posted from the Cochrane Consumer Blog.

The reality is that many who read Cochrane reviews (including clinicians, policymakers, medical reporters) do not read beyond the plain language summary and the abstract. Inclusion of the following information in the abstract and PLS of Cochrane drug and device reviews is key when relevant:
1) State when all or most of included trials are funded and/or conducted by drug or device makers;
2) State when the authors have requested harms data but this has been refused or the request not answered, as well as selective reporting of harms data;
3) Avoid expressing results in relative risk reduction terms (see the new Cochrane statistical formats review for alternatives that are not as confusing to consumers and health professionals); and
4) State the magnitude of the benefit whenever a benefit is identified.
To leave out this crucial information from the abstract and the PLS would deprive a significant portion of the Cochrane review “audience” of crucial information needed to make an informed decision whether they are deciding to prescribe a drug, take a drug or make reimbursement policy for a drug.
It would also be helpful to include a section in the abstract and PLS entitled, “Caveats,” where industry funding is noted when relevant. Here is an example of such a format from an excellent, physician-run website (www.TheNNT.com), which, by the way, uses Cochrane reviews frequently as a source:
“Caveats: Virtually all of the major statin studies were paid for and conducted by their respective pharmaceutical company. A long history of misrepresentation of data and occasionally fraudulent reporting of data suggests that these results are often much more optimistic than subsequent data produced by researchers and parties that do not have a financial stake in the results.”
It is difficult to separate the science from the marketing now that industry has taken over the lion’s share of drug/device research. Contributors give time to The Cochrane Collaboration because we see it as the rare independent evaluator of research findings.

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