The decisions we make as individuals about health care treatment are complicated and based on many factors. Health information is one factor. Think about it. When you’re not feeling well and trying to decide what to do, where do you go for information? If you’re like me, you type a few search terms into Google and browse the top results. However, for many conditions, such a search yields a massive amount of information—some of which is contradictory. Some information may even conflict with what you know from experience or what a doctor or other trusted person has told you. So how do you know which information to believe when making a decision?
With 21st century technology, you can make decisions based on the latest and best health information from research if you know where to look for it. Unfortunately, information touted on the internet by fear mongers and marketers often drowns out evidence-based health information (evidence-based means information from credible, reproducible, high-quality research).
There is an excellent and free resource I always go back to for guidance: the Cochrane website (www.cochrane.org). Cochrane produces systematic reviews of primary research in medicine and is considered one of the most reliable sources for up-to-date and evidence-based information. Cochrane has done systematic reviews for lots of research questions. Want to know if Vitamin C works for the common cold? They covered it. Want to know about herbal remedies for osteoarthritis? Done. A systematic review synthesizes all of the high quality research that answers a particular question. It’s important to remember that science is incremental and that one study is almost never enough. Instead, accepted scientific facts rely on statistical probability and reproducibility of findings. In other words, just because one study finds what looks like an answer, “it ain’t necessarily so.” Facts get established over time as multiples studies of a specific research question get the same results over and over again.
Cochrane is used by doctors, health care professionals, and policy makers to keep current on the latest findings. The site also offers excellent patient summaries and podcasts of research results in everyday language for a variety of conditions and treatments.
You can see the most popular recent medical evidence and link to Cochrane’s archive of research with a search option on the Our Evidence page. This portion of the website includes Cochrane Reviews which are summaries of clinical research reviews (full versions can be found at the Cochrane Library) accessible to anyone. The archive of research features many topics, including “Rheumatology.” These topics are further broken down by specific condition.
To demonstrate the ease of accessing specific, patient-friendly clinical research on Cochrane, let’s look at an example. When viewing rheumatology reviews, you can select from a number of medical conditions in the left-hand dropdown menu. Selecting “rheumatoid arthritis” presents you with a number of hits. Choosing one of the Cochrane reviews–“Rituximab for rheumatoid arthritis”–you can see a short plain-language summary of the research published up to January 2014 on the effect of rituximab for people with rheumatoid arthritis. Below, there is information presented in easy-to-read Q&A format. Definitions for underlined terms in the text can be found by hovering your mouse over the word. The full systematic review can be found by clicking the navy blue box labeled, “See the full Review on the Cochrane Library.” Amazing, right? You have access to the same scientific evidence as the best doctors in the world.
If a podcast of a particular review is available, there will be a purple button on the right-hand side that says, “Listen to the podcast of this review.” For those of you who are interested primarily in accessing podcasts, you can filter your search results by checking the box on the left-hand navigation menu labeled, “Has podcast.” Or, you can directly browse the available Cochrane Podcasts on “The latest Cochrane Podcasts” page where you’ll see “Search for Podcasts” halfway down. These podcasts are also available on iTunes! The Podcasts for each topic also provide links if you prefer to read the Summary of the Review or the Full Review. Here are some examples of RA and OA Podcasts that you might find interesting:
- Topical herbal therapies for treating osteoarthritis
- Oral or transdermal opioids for osteoarthritis of the knee and hip
- Transcutaneous electrostimulation for osteoarthritis of the knee
Rheumatoid Arthritis (RA)
- Folic acid and folinic acid for reducing side effects in patients receiving methotrexate for RA
- Biologics for rheumatoid arthritis: An overview of Cochrane reviews
- Abatacept for RA
- Dynamic exercise programs in patients with RA
There’s more on the Cochrane site, but I recommend perusing the two resources I’ve highlighted above (“Our Evidence” and “Podcasts”). Please comment below to share your own Cochrane experience. What topics or research questions did you look up? Are there unanswered questions for which you think we should use Arthritis Power to investigate? I’ve heard many people with RA and spondyloarthritis express interest and concern about the following research question: What are the long term effects of being on a biologic (i.e., level of risk of serious infection or malignancy)? This is a question that applies to many Arthritis Power members. A study like this could also involve some of our partner networks within the National Patient-Centered Outcomes Research Network (PCORnet) since biologic medications are common across several other conditions. Please share your thoughts.
Our amazing Summer Associate Nicole Schachman from Middlebury College worked with Dr. Ben Nowell contributing background research and writing on this post. Kudos to her!