The general public may not be reading the Archives of General Psychiatry or the New England Journal of Medicine, but they are basing important health care decisions and lifestyle changes on the research findings that these and other journals publish, particularly when such findings concern risk factors. Moreover, these scientific reports frequently are interpreted by clinicians, policy makers and the news media as calls to action, only later to be refuted or questioned by conflicting studies that may even claim serious and harmful consequences from those actions.
"What is a risk? What is a risk factor? Are all risk factors equal? What is the threshold for true clinical significance? The general public can't be expected to understand these questions, let alone know the answers. Yet, ultimately, they are the ones who are most affected by journal articles that include words like 'risk' that even some of us working in research are not accurately defining," David J. Kupfer, M.D., the Thomas P. Detre Professor and chairman of the department of psychiatry at the University of Pittsburgh School of Medicine, told his colleagues at the American Psychiatric Association Annual Meeting.
Researchers must be more rigorous in how they design and conduct clinical studies as well as be more mindful of the language they use to describe their findings in the scientific literature or in writing reviews of other research, asserted Dr. Kupfer in a session devoted to discussion about risk factors in medicine and psychiatry.
Dr. Kupfer is co-author of the recently published To Your Health: How to Understand What Research Tells Us About Risk (Oxford University Press, 2005).
According to Dr. Kupfer, a look at the past year's newspaper headlines about antidepressants being linked to increased risk of suicide in children and adolescents exemplifies how research influences society and yet can paint a confusing picture.
"In truth, these studies, which received much attention from the press, overestimated the risk and underestimated the benefit of prescribing antidepressants to children and teens. But clinicians and parents alike were at a loss to understand their meaning."