Health Quackery Exhibit

Health information literacy and critical thinking to the rescue

Quackery is a fuzzy concept that can be defined in broader or narrower terms, but here I will use the concept to touch upon health fraud, bad science, pseudoscience, and misinformation. Health quackery has come in many forms over the ages (both outside and within the medical establishment), but it seems fair to say one antidote is a combination of health information literacy and critical thinking.

The April exhibit on the main floor of the Redpath Library Building is a playful attempt to capture a few of the historical and contemporary issues related to the subject, while also drawing on some resources that may be useful in developing a critical approach to the marketing of health products and services. Here I have selected a sample of authors who have written directly or indirectly on the topic.

Books by Ben Goldacre

Cover image of the book Bad Science, by Ben Goldacre
Cover image of the book Bad Pharma, by Ben Goldacre

Ben Goldacre, known in part for a column he penned in The Guardian, has written accessible books such as Bad Science and Bad Pharma, taking a critical look at alternative approaches as well as the pharmaceutical industry. He is a proponent of open science and runs the Bennett Institute for Applied Data Science.

Books by Paul Offit

Paul Offit is a pediatrician specializing in infectious diseases with expertise in vaccines, immunology, and virology, and his work contributed to the development of a vaccine for rotavirus. He is an interesting example of the complexity of being publicly accepted as a trusted figure when you are seen as having a conflict of interest (COI), financial or otherwise. That said, anybody trying to sell you some kind of health product or service, pharmaceutical or not, can be accused of a potential conflict as well, and many such figures do not disclose or admit their own COIs.

Books by Jen Gunter

Jen Gunter, a gynecologist who has written for the New York Times, is not afraid to call out celebrities for their questionable health claims. She is an advocate for women’s health.

Books by Timothy Caulfield

Timothy Caulfield is a Canada Research Chair in health law and policy at the University of Alberta. He takes fun pokes at celebrity “health” culture. You can also find him on Twitter.

Books by Joe Schwarcz

Joe Schwarcz is one of McGill’s resident skeptics when it comes to health quackery and has written many books which may be of interest to critical minds. He is the Director of the Office for Science and Society and seeks to elevate the level of critical thinking applied to health and scientific claims.

Critical thinking and health information literacy

Antidotes to health quackery include critical thinking and health information literacy. There are many problems with medical research and valid criticisms with regard to relying too dogmatically on certain study designs as best evidence, for example, but the accumulation of science-based knowledge is an evolving process, studies can be badly or well done, and we need to learn to be comfortable with uncertainty while able to appraise–at even a basic but solid level–the available evidence.

Regulation

Health quackery flourishes in unregulated environments. Regulation is one way in which the public is protected from false or overreaching claims. Knowing more about how food, drugs, and other products are regulated helps understand why some seemingly outrageous claims still seem to make it through the protections in place.

Assessing health information

Some other potential remedies when seeking trusted health information and interpreting health research:

Online Health Information Aid

How to Read a Paper

Look It Up! What Patients, Doctors, Nurses, and and Pharmacists Need to Know about the Internet and Primary Health Care

Users’ Guides to the Medical Literature

Many thanks to Joe Schwarcz for providing the community with his critical perspectives on the topic, as well as for loaning us some interesting examples of products marketed to consumers for their presumed health benefits (check out his Facebook video). The ducks are also thanks to his extensive collection.

A big thank you to Tamanna Patel, Mary Yearl, Lucy Kiester, and Amanda Wheatley for their invaluable help with this exhibit! Any sources of criticism are entirely the responsibility of Genevieve Gore.

List of library items on display and other related items

Citizen Science and the Cochrane Crowd

Are you interested in citizen science and health research?

Consider becoming a member of the Cochrane Crowd! The Crowd is a Cochrane initiative inviting volunteers to contribute to high quality, independent health evidence. Cochrane is a global, not-for-profit network of researchers aiming to gather and summarize research evidence to improve health outcomes. Research output has grown exponentially and there is a significant need to sift through large quantities of research on whether treatments work or how accurate diagnostic tests are, to name but a couple of examples.

Finding and classifying all the research on a given intervention or topic can be unfeasible for research teams with limited resources. This is where the Crowd comes in: Volunteers for the Cochrane Crowd help identify and categorize research by contributing to tasks such as screening records to pick out randomized controlled trials or studies on COVID-19. Just a few minutes a day can make a big difference when many hands make light work. Check out their FAQ for common questions and answers, and join the Crowd. You’ll be surprised by what you learn along the way.

Discovering and accessing health sciences data at McGill

Discovering, accessing, and manipulating data are often necessary tasks in health sciences research and beyond, and they can be particularly tricky. There are a few resources that I would encourage you to check out for these purposes:

  • There is a Data Lab in the McGill Library! Located on the second floor of the McLennan Library Building, the Lab has workstations equipped with ArcGIS, MATLAB, NVivo (limited number of licences), R (guide), SAS, SPSS, STAT/Transfer, Stata, and more. As of Feb. 2018, the Data Lab has walk-in hours too from 10 am to 2 pm Monday through Friday, during which you can get basic support
  • Have you taken a look at the Numeric Data guide? Resources are broken down by subject and the guide provides information on the difference between aggregate and microdata, how to cite data, and more
  • McGill has access to Statistics Canada public use microdata files, mainly through the <odesi> portal
  • McGill has access to the Discharge Abstracts Database (DAD) through the Canadian Institute for Health Information (CIHI) and <odesi>
  • You can request access to the Postal Code Conversion Files (PCCF) (2016 is here!) by emailing data.library@mcgill.ca. Our license for the PCCF does not allow for distribution through a third-party portal such as <odesi> (just the metadata for the PCCF is there), but we’re looking into a secure, local dissemination model that will meet new license requirements. (Clarification added 19/02/2018–thanks, Berenica!)
  • Did you know that as a graduate student you can request access to the Canadian Institute for Health Information (CIHI) microdata and Statistics Canada master-level files? Our Numeric Data Librarian, Berenica Vejvoda, is a great resource person to help you figure out if you need access and to walk you through those processes

Some other useful and hard-to-find resources include:

There is also a small budget for one-time data purchases, and knowing what people need, even when the budget is too tight for an immediate acquisition, helps the Library plan for future purchases.

Feel free to contact your Liaison Librarian too!

 

 

Examples of point-of-care tools your doctor is using: UpToDate vs. DynaMed

Health information is often difficult to navigate. Try a quick PubMed search and you’ll instantly get a sense of the number of published articles that are out there, and that’s not even everything (Tip: Filter your results using the article type “systematic reviews”–not “reviews”–to narrow down your results, and favour Cochrane reviews for their rigor; alternatively, use PubMed Clinical Queries).

Where am I going with this? Well, clinicians are busy people and it is obviously really important for them to stay on top of things. How are some ways they do this using McGill-licensed resources? These resources just happen to be available to the entire McGill community, so they are worth a look even if you are not a busy clinician.

Many clinicians are huge fans of UpToDate. It’s a really expensive resource and one we have great trouble affording, but it is definitely worth a look. It’s easy to use (designed for free text searching; look for your terms within articles using CTRL-F on a PC or CMD-F on a Mac if they’re not in the article title). Evidence is not always graded, although they are improving this.

An alternative to UpToDate and a nice option if you’re an avid mobile device user is DynaMed. We began licensing it this past spring, and one key advantage of it over UpToDate is that you can download all the content onto a mobile device, which means you don’t need an internet connection to view it. The app is a bit clunky but the content is there. Levels of Evidence are pretty consistently applied.

Health is important to just about all of us, so why not give these point-of-care tools a try?

Thinking of taking the MCAT? Try the Khan Academy resources

The Khan Academy is a not-for-profit seeking to provide free education to “anyone, anywhere.” It sounds a lot like a MOOC site, but it doesn’t seem to call itself that, which is fine by me. Their health content is categorized under science, which is also fine by me: The library staff (including librarians and yours truly) and the collections of the Life Sciences Library recently moved, in large part, to the Schulich Library of Science and Engineering, so this comparable categorization makes me feel even more at ease in our new Schulich home.

But let’s get back to the subject line. One of their collections, MCAT, is being developed as a study aid for the revised release of the MCAT (Medical College Admission Test) due out in 2015; this is being done in collaboration with the Association of American Medical Colleges (AAMC) and the Robert Wood Johnson Foundation. The MCAT is not a required examination for all categories of prospective medical students at McGill (depending on the type of applicant) but is commonly required in Canada and in most of the US medical schools.

This is poised to be an excellent resource for students of any age seeking new knowledge, refreshers or tutorials on specific topics. The Khan Academy covers other subjects as well, such as calculus, inferential statistics, and organic chemistry. There are also plans to put together a collection for the NCLEX-RN licensing examination for nursing, which is, according to Dr. Rishi Desai (Program Lead – Medical Partnerships, Khan Academy) quite similar to the USMLE (United States Medical Licensing Examination).

McGill plug: One of their team members is a McGill grad!

I just logged in with my Gmail account (super easy) and was faced with a math test. Despite the badge I got for completing what is probably quite a basic test, I did really, really badly. Perhaps I should get my basic math concepts down before looking at MCAT content…