There's EBM, and then there's just plain rolling your eyes

So, here's the thing. For all my teasing of my more medically oriented friends (and the number of times I'll whip out the BMJ "demand" for an evidence-based trial of parachutes), I do actually acknowledge that regardless of whether something is considered folk wisdom, or a general truism, you do need to actually place some factual evidence, numbers, and etc to it. And if this weren't a general human desire, shows like Mythbusters and websites like Snopes wouldn't be so popular.

But occasionally, occasionally, you get a study that's so, for lack of a better way to describe it, "duh" that you've got to just roll your eyes. One such study hit the wires last night, and I'll just let you see the Reuters headline and let you judge for yourself:  Study Probes Why U.S. Blacks Wary of Medical Trials .

Let that one sink in a minute, and then ask yourself if you need to read the article to know the answer.

I realize that for many people, Tuskegee is an appendix to their history class, and they might not read much about it after high school. But I find it almost impossible to believe that anyone who's even a department away from medical studies of any kind could be so, well, to put it politely, confused.

Some choice quotes from the Reuters article include: Distrust of doctors and concern over being abused as human guinea pigs may explain why U.S. blacks have been less willing than whites to volunteer to take part in medical studies...

Researchers at Johns Hopkins University in Baltimore went through the process of recruiting volunteers to take part in a mock clinical trial testing a pill to treat heart disease....

They found that 58 percent of blacks, compared to just 25 percent of whites, said they believed doctors use drugs to experiment on people without a patient's consent.

    In addition, 25 percent of the blacks, compared to 15 percent of whites, expressed the belief their doctor would be willing to ask them to take part in a study even if the study might harm them. And 28 percent of blacks, compared to 22 percent of whites, said their doctors would be willing to expose them to unnecessary risks.

And perhaps my favourite quote,

Dr. Neil Powe, one of the Johns Hopkins researchers, said the reluctance of the blacks to volunteer may be a legacy of past abuses like the infamous Tuskegee syphilis experiment. "That may have led to distrust of medical research, particularly by African Americans."

Really? Who would have thought.

Now again, I do honestly understand the need for actual quantifiable numbers in research. But the tone taken here, that black American's distrust of the medical and research establishment might have something to do with one of the greatest injustices of research ever perpetrated, stretches credulity to its limit. (And of course, as anyone familiar with the sad history of medical research and human experimentation knows, Tuskegee is not the first or only example of black Americans being used as guinea pigs by unscrupulous doctors and researchers.)

This is certainly ground that has been well-covered, at this point. There are numerous books that discuss the legacy of Tuskegee, and cover the lingering effects and trust issues from those experiments. What we need now is not numbers focusing on the past and how it affects the present, but instead thoughtful ideas on how to repair a badly broken trust.
-Kelly Hills

Comments

[Daniel Goldberg]

Agreed, completely. I deal with this issues every day in my work. But you'd be surprised how much resistance I encounter on this issue, in no small part because of the Wendler et al. study. Are you familiar with it?

http://medicine.plosjournals.org/perlserv?request=get-document&doi=10.1371/journal.pmed.0030019