What are the most reliable sources of information on the coronavirus, and what are the arguments that advocate for their reliability?
In the turmoil caused by the current pandemic, one can more easily see our tendency to listen to all kinds of theories circulating on various media channels. Since they contradict official information, these theories carry the explicit or implicit accusation that the medical authorities are lying to us. Such information fuels distrust of quality medical information. I will try to explain, in the lines that follow, what medical science really is and why official positions are still the most trustworthy.
Primary information: a mountain
Medical science is based on research, the results of which are published in specialized medical journals. Research is of various types: laboratory experiments (on animals, on cell cultures), observations made on patients, studies on the human body with advanced technical means, epidemiological studies, interventional studies (in which a treatment is applied and the results are observed), and so on.
All of this research is primary, or raw, medical information. The volume of primary health information is higher than most people imagine—hundreds of thousands of new research papers come out each year, and the research quality is the first differentiation criterion (some scientific studies may contain methodological errors that invalidate their conclusions).
How do we pick the real cherry?
As expected, information coming from primary sources is varied and sometimes contradictory. In this mountain of information, one can come across data that is anti-alcohol, but also pro-alcohol, pro-vaccine as well as anti-vaccine, anti-smoking as well as pro-smoking. This brings us to the biggest problem of documentation: cherry picking.
The term cherry-picking refers to what happens when someone picks cherries. Whether they are careful or they do it mechanically, the person in question will tend to select the most ripe, most good-looking fruit. Those who analyse the cherry bucket at the end will believe that this is what all the fruit on the tree looks like—but that would be a mistake.
This misconception explains the fact that different doctors and researchers may present contradictory information to the public, which they support with the studies they have selected and in which, most likely, they themselves strongly believe. The temptation to formulate theories other than the official ones is strong. Originality can make someone famous quickly, and celebrity brings influence and money.
The advantage of official positions
Official positions are not based on primary information, but on secondary or tertiary information, which are in fact primary information processed by competent people, who specialized in medical research, who have the appropriate knowledge, experience, and tools to study primary information. The advantage of primary data processing is that everything that has been researched in the respective field of interest is taken into account, eliminating only research that has used an incorrect methodology. Moreover, teamwork is key in primary data processing, which significantly reduces the risk of error.
The sources of processed information include syntheses, meta-analyzes, synopsis, and summaries. Based on them, practice guides and complex computerized systems are developed, which assist doctors in determining the best treatment for a particular case. Tertiary information is compiled on the same basis, i.e. manuals and treatises, in which the information’s aspect resembles that which we can find in textbooks.
I am not saying here that secondary and tertiary information is perfect and 100% true. If it were so, we would not need to review it regularly. However, there is the highest possible probability that it is correct compared to the theories that circulate in parallel.
Where do we go for information?
Medical professionals turn first to treatises and practice guides. This is where the safest information can be found. For more detailed or up-to-date information on a particular topic, they resort to secondary sources. Sometimes doctors have to search through primary sources, but caution must be exercised here.
For those familiar with medical language, materials are available, prepared for non-professionals by medical authorities. In English you can access, for example, the World Health Organization website (who.int), which has a rich section of questions and answers related to COVID-19, or the website of the US Centers for Disease Control and Prevention (cdc.gov).
We need to approach medical information with the willingness to learn. Experts are constantly striving to provide the most accurate overview, based on all up-to-date information. Jeffrey Beall, an American researcher in the field of librarianship, is known for making a list of journals or sites that publish, on a fee basis only, insufficiently verified or false information.
You can consult the list at beallslist.net. It is important to resist the temptation to select information that confirms certain preconceived notions or various original theories that are dear to us. We should also resist giving credit to the various conspiracy theories, which simply blow up an intelligent and efficient medical information processing structure. Toying with medical information often means playing with human lives.
Dr. Ionel Bratu is a cardiologist and the chairman of the Health and Education Association in Brăila, Romania.