MANY of us watch television and have become intrigued by medical shows that we find fascinating, if not informative. Some of us do not visit doctors unless we are ill, and sometimes despite being ill. When we do visit, there is very little time for the doctor to talk, in detail, about our bodies and what may or may not have gone wrong with it. The possible causes and the ways in which our decisions and actions may have influenced our medical condition are even less discussed.

Any recommendations made for effective action are sometimes very brief, and many receive only prescriptions. And frequently, there is little time for doctors to ask questions to ascertain whether we have fully understood our medical condition and are motivated to take the requisite corrective action.

Many in our country do not have time to read, and so rely mainly on what they hear, whether by radio, television or people say, for their general information. Consequently, while many people may watch medical television shows for solely entertainment purposes, since we can all relate to the health issues or subject matters raised in these shows, then chances are that a significant portion of our population may actually be using these shows as their main source of medical information.

NO EVIDENCE FOR MOST TV MEDICAL ADVICE

Interestingly, a study of the media by researchers at the University of Alberta, which was recently published in the British Medical Journal, has warned persons to be sceptical about claims and recommendations made on mainstream television medical talk shows. In many cases, the researchers found that specific details were lacking regarding the magnitude of the expected benefit, the risk of harm and the cost and inconvenience of following the recommendations. Further, the evidence supporting the claims was either contradictory or absent, and so viewers had little basis for any informed decision-making.

In the study, 40 episodes of widely watched programmes like The Dr Oz Show and The Doctors were assessed, and the recommendations made on the shows evaluated. The shows typically featured a host, or hosts, and guests discussing one or more health topics per episode, and making average 11 or 12 recommendations to consumers, with some recommendations being stronger than others. Visiting guests often provided between 33 per cent and 65 per cent of the recommendations made on health issues. To critically assess the content of these shows, experienced evidence reviewers independently searched and then formed a team that evaluated the evidence for the stronger recommendations made.

General medical and public health advice were the most frequent topics, followed by non-weight loss dietary advice, such as immune-boosting diets. The combination of dietary and weight-loss advice represented 43 per cent of the topics discussed. Exercise took a definite back seat when compared to diet, as dietary advice accounted for 39 per cent of recommendations while exercise accounted for five per cent. Potential conflicts of interest by the hosts and their guests were acknowledged only four times out of the 924 recommendations made.

FOCUS ON POTENTIAL BENEFIT VERSUS POSSIBLE HARM

A specific benefit was mentioned for only about 40 per cent of the recommendations made, and mentioned even fewer times were the magnitude of the benefit (mentioned in less than 20 per cent of the recommendations), the possible harms (mentioned in less than 10 per cent of the cases), and the associated costs (mentioned only in 15 per cent of the recommendations). Only 54 per cent of the recommendations made had any published evidence to support them. Further, the researchers found that approximately half of the recommendations made on the television shows had either no evidence or were contradicted by the best available medical evidence.

The issue was further compounded by the complexity of the shows, the subjective nature of much of the advice given, and the difficulty of distinguishing between what was said and what was implied. This, therefore, raises the issue of whether medical talk shows should provide more than simple entertainment. The researchers concluded that if the medical television shows are perceived as providing medical information or advice, then viewers need to realise that the recommendations made on the shows may not be supported by higher evidence or presented with enough balanced information that is needed for adequate, informed decision-making.

SOURCES OF RELIABLE HEALTH INFORMATION

Where should we therefore look for reliable medical advice in Jamaica? It exists among peer-reviewed medical publications, but these are generally inaccessible to the general public, and frequently require interpretation and detailing by busy doctors. Bringing important health information to the public regularly will require resources that are in short supply in the public sector, and the private sector will be seeking to ascertain how they will benefit financially from such an investment. Perhaps this presents an opportunity for non-government organisations and service clubs to fill a gap.

Derrick Aarons MD, PhD is a consultant bioethicist/family physician, a specialist in ethical issues in medicine, the life sciences and research, and is the ethicist at the Caribbean Public Health Agency – CARPHA. (The views expressed here are not written on behalf of CARPHA)