Friday, August 3, 2018

When Patients Come In Quoting ‘The Dr. Oz Show’

If you’re a clinician, you know about the Dr. Oz phenomenon – when a patient comes in asking questions about something that was hear on The Dr. Oz Show. “Should I take that berry to lose weight?” “Will that root extract boost my immunity?” “Can this supplement really prevent cancer?”

Sometimes you know right away that the answer is no. Other times you may not be so sure. My colleagues and I decided to look into the claims being made on two shows: The Dr. Oz Show and The Doctors. Overall, we found that the recommendations made on these shows were only occasionally based on high –quality, evidence-based data. Often, we couldn’t find any literature or medical studies to confirm or refute the claims made on the show. Moreover, the costs and harms of the suggested treatments were often overlooked.

We also discovered that the hosts of the shows frequently discussed products made by companies that advertise on the shows. How did we discover this? We enlisted a group of medical students to tape and view all episodes of The Doctors and The Dr. Oz Show for a full month. The students logged all health recommendations made on these shows, whether harms or cost were discussed, and whether a source or reference was mentioned. They noted the advertisements that were aired during the show and tracked whether the advertisements were related to the show’s content to see if there were any conflicts of interest.

We counted more than 300 health recommendations, with an average of about 6.9 per day on the Dr. Oz Show and 9.5 on The Doctors. Discussion of potential harms or risks was noted in only about 8.6% of Dr. Oz’s recommendations and about 13% of The Doctor’s recommendations. The costs and interventions were mentioned about 23% of the time on the The Dr. OZ Show and only 3% on the time on The Doctors. Statements on The Dr. Oz Show agreed with evidence-based medical guidelines 22.7% of the time. For The Doctors, it was about 20%.

We also found that more than half of all recorded shows had content linked directly to advertisements. For content on The Doctors, a majority of the associated literature found was statistically insignificant or required extensive extrapolation. No literature support was found for 31-36% of recommendations; when included, 36.6% had recommendations with an Oxford evidence-based classification of 3b or lower, which is at the lower end of what is considered good-quality evidence. The Dr. Oz Show had similar results, with supporting literature being statistically insignificant or requiring extrapolation in about 50% of the recommendations. We couldn’t find any supporting literature for 40.9%, and about 31.8-40.9% had evidence-based classification of 3a or lower.

My Take:
These shows are all about selling product. A good example of extrapolation is Prevagen. The original studies on mice injected this jellyfish protein directly into the brain. The mice did show some memory improvement over controls. However, when you ingest protein, it gets broken down into amino acids prior to absorption, so no intact “Prevagen” enters the blood stream much less crosses the blood-brain barrier. More recent studies with humans did show some mild improvement in memory for people with mild or no memory impairment, but overall the improvement was not statically significant. There was no improvement in people with documented cognitive impairment.

Bottom Line:
Both these shows take promising concepts in nutrition and bastardize the information for profit. It’s just like the drug industry on a smaller scale. There is some good information tucked between the misinformation that gives all nutritionists a bad name. I don’t even watch them for the entertainment value.

Source: July 26, 2018 Medscape

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