Friday, November 15, 2013

The Cause and Effects of Health and Disease

First published in The Vault Magazine, November 15, 2013

This is the first in a series of articles that will run in The Vault.  As part of the agreement with the editors, I will not publish the article on my blog until 1 week after publication in The Vault.  Feel free to comment on the blog or send comments to the e-mail below.  Enjoy!

In 1853, a cholera outbreak struck a neighbourhood in London.  A bright physician named Dr. John Snow questioned the prevailing wisdom and was certain the disease spread through some mechanism other than “foul air.”

Through a meticulous and systematic investigation, he traced the source of the outbreak to the Broad Street water pump, into which had been leaking human excrement.  The pump handle was removed and, shortly thereafter, the local outbreak ended.

This proved Snow’s theory.

After Snow’s death, Louis Pasteur demonstrated the germ theory of disease and Robert Koch isolatedVibrio cholerae, the responsible bacteria.

For his methodology in isolating the source of an illness, Dr. Snow is widely considered the father of epidemiology, the study of the patterns, causes, and effects of health and disease.

The study of health and illness has since expanded and for even the most obscure clinical query, there are usually numerous researchers who have looked at it.  This poses a problem though.

If ten researchers study the same problem, but five get one result and the other five the opposite, who is correct?

Archie Cochrane, a medical researcher, had the solution.  He created a group that would later become the Cochrane Collaboration.  Their first project collected all the studies that had ever been done on giving drugs called corticosteroids to women in premature labour and brought all the data together to provide the best answer.

Doing this, they found this simple intervention cut in half the risk of infants dying from the complications of prematurity.

Because no one had systematically reviewed the research until that point, many infants needlessly died because clinicians were unaware of an effective intervention.

That is the power of clinical epidemiology.

That is what this column is about, but not in an esoteric way.

I want to look at the questions that matter to you, but with an eye to the evidence.

No myths.  No miracles.  Just the real deal.

Questions like:

What is the least effective but most commonly used method to lose weight?

Does anything Dr. Oz recommends actually work?

Are multivitamins necessary for healthy people?

Is the shingles vaccine effective?  Is it necessary?

All questions are fair game so long as they are not of a specific personal nature. I cannot treat you through this column, only educate you and do some good old-fashioned myth busting.

Along the way you’ll learn about tricks drug companies and researchers play, why even the most astute clinicians are still working with incomplete information, and why you can disregard almost everything about health you read on the internet and in the newspaper, or see on TV.

I’ve got plenty of material to work with, and will if need be, but I’d prefer the readers to lead the discussion.

So send your questions to nickonchuks@gmail.com and check back in the next issue for more.

1 comment:

Cousin Shirley said...

I would like to read your answers to all four of the "questions like these" you proposed. Especially the shingles question and also can a person get shingles more than once and is "Ramsey Hunt Syndrome " a form of shingles?