Drs Camilla Alderighi and Raffaele Rasoini write about an important project to improve health literacy. These words tempt you to be optimistic! Thank you @camialderighi @RasoiniR
Great article! Can we bring that to the US? Critical thinking is something we don't teach in schools anymore. It would be great to be able to share that knowledge beyond a Sensible Adult direct circle of influence. We need more of this. thank you
I would love to know how to teach this to my own children, as my state education system has zero interest in teaching students to think for themselves.
As I read their beautifully reasoned example from a 5th grader: "I would say it doesn’t look like a fair comparison at all: assignment to groups wasn’t done by chance, since folks chose whether they would take the drug or not. This means the two groups are not similar, and the results may be unreliable. Plus, too few people were involved in this study."
I wondered, "Why not teach adults?" and read, "They quickly realized how hard it was to teach (critical) health literacy to adults. Unlike children, adults have limited time, many prejudices, and entrenched narratives that make most of them impervious to new concepts, especially when old concepts feel jeopardized."
I thought, surely they must be mistaken. It couldn't possibly be that hard. Then I read the comments here, many of which unfortunately, ironically strongly confirm and validate the authors' approach.
"Sensible Medicine " is off to a shaky start. "My First Patient" was insightful and sensible, but the content of the others has been disappointing so far. The many cogent, insightful responses given in the comment section have brought more clarity and reasoned analysis to the topics than the articles. I appreciate those who take time to think through the issues and respond, including for this article, and for those I'll keep reading.
I think we might agree that education about health care options is a good thing. It's not at all clear why the HCQ example had to be used to demonstrate that point. The message I got was even an fifth grade student can see that HCQ was not validated by the chosen study with the underlying implication that HCQ has no evidence for effectiveness and you well educated readers have been fooled. Perhaps the example hit a touch point for me, but I imagine there could be much better targets than a single HCQ study. If the writers has said FNM (Fine New Medicine) rather than HCQ it wouldn't raise my hackles so much. As such, the excellent point about education was lost.
Did anyone tell those children that HQC was found to be effective in treating SARS-COV-1 over a decade earlier?
That study may be weak, when considered in isolation, but I'm afraid you are being selective. They could have used many Pfizer studies or mentioned drugs that were wrongly considered safe Vioxx etc.
Medical fraud is almost exclusively the work of the Pharma industry and ignoring that to point out one study which lacks strength is shockingly biased, even dishonest.
I'm afraid that bias is totally contrary to evidence based medicine. The BMJ article which recently claimed 70% of drugs on the market are probably NOT based on evidence.
It goes beyond teaching laypeople about evidence-based medicine.
The original randomized Pfizer and Moderna vaccine trials showed many times more vaccine-induced "severe adverse events" than vaccine-prevented "severe COVID-19". Yet, nearly all MDs and most academic luminaries are rah-rah for the vaccines.
Is there a similar effort underway to get more people or organizations to actually link to the studies in question (as was done here)? You'd think this would be more prevalent in the internet age, but sadly no.
This would be OK if the teachers also carefully pointed out EBM failures, limitations, pernicious influence of funders, and the questionable or contestable aspects of many RCTs.
Another, more down-to-earth problem is that in the real world, few schoolkids and teens - even the bright ones - will be truly interested or will remember much.
Yikes. I agree it's imperative to improve health literacy and critical thinking skills but why use this one study on hydroxychloroquine as the example? Researchers have known since SARS-1 that it was an effective treatment. This has been buttressed by reliable studies, meta analyses. We also know - like ivermectin - that it's proven to be a safe medicine and causes v. few adverse side effects unlike the drugs approved to treat Covid-19 not to mention the so-called vaccines. So even if - in the end - it's not as effective as we might hope it won't hurt patients if prescribed early and at the correct doses.... Why not use the flawed Pfizer clinical trials on the mRNA injectables to improve health literacy instead? Talk about a doozy.
I would be more um "optimistic" if the doctors had chosen a big pharma study. If you're going to teach kids to think critically, choose a study on something you believe is effective.
Great article! Can we bring that to the US? Critical thinking is something we don't teach in schools anymore. It would be great to be able to share that knowledge beyond a Sensible Adult direct circle of influence. We need more of this. thank you
I would love to know how to teach this to my own children, as my state education system has zero interest in teaching students to think for themselves.
I'd like to give the decision makers at the CDC this health literacy test to see if they can beat a fifth grader.
They can start with "Dr" Tedros. First teach him elementary maths. Apparently to him, 9 = 6 = deadlock!
As I read their beautifully reasoned example from a 5th grader: "I would say it doesn’t look like a fair comparison at all: assignment to groups wasn’t done by chance, since folks chose whether they would take the drug or not. This means the two groups are not similar, and the results may be unreliable. Plus, too few people were involved in this study."
I wondered, "Why not teach adults?" and read, "They quickly realized how hard it was to teach (critical) health literacy to adults. Unlike children, adults have limited time, many prejudices, and entrenched narratives that make most of them impervious to new concepts, especially when old concepts feel jeopardized."
I thought, surely they must be mistaken. It couldn't possibly be that hard. Then I read the comments here, many of which unfortunately, ironically strongly confirm and validate the authors' approach.
"Sensible Medicine " is off to a shaky start. "My First Patient" was insightful and sensible, but the content of the others has been disappointing so far. The many cogent, insightful responses given in the comment section have brought more clarity and reasoned analysis to the topics than the articles. I appreciate those who take time to think through the issues and respond, including for this article, and for those I'll keep reading.
I think we might agree that education about health care options is a good thing. It's not at all clear why the HCQ example had to be used to demonstrate that point. The message I got was even an fifth grade student can see that HCQ was not validated by the chosen study with the underlying implication that HCQ has no evidence for effectiveness and you well educated readers have been fooled. Perhaps the example hit a touch point for me, but I imagine there could be much better targets than a single HCQ study. If the writers has said FNM (Fine New Medicine) rather than HCQ it wouldn't raise my hackles so much. As such, the excellent point about education was lost.
Thank goodness they made sure to paint HCQ in the most unfavorable light while teaching those valuable critical thinking skills.
I wonder if there was an original draft where that sentence said "remdesivir" or "community lockdowns" or "mask mandates."
No sense teaching them dangerous ideas, after all.
"Not even a whiff of ideological bias in this post!"
- every zombie ever
Did anyone tell those children that HQC was found to be effective in treating SARS-COV-1 over a decade earlier?
That study may be weak, when considered in isolation, but I'm afraid you are being selective. They could have used many Pfizer studies or mentioned drugs that were wrongly considered safe Vioxx etc.
Medical fraud is almost exclusively the work of the Pharma industry and ignoring that to point out one study which lacks strength is shockingly biased, even dishonest.
I'm afraid that bias is totally contrary to evidence based medicine. The BMJ article which recently claimed 70% of drugs on the market are probably NOT based on evidence.
It goes beyond teaching laypeople about evidence-based medicine.
The original randomized Pfizer and Moderna vaccine trials showed many times more vaccine-induced "severe adverse events" than vaccine-prevented "severe COVID-19". Yet, nearly all MDs and most academic luminaries are rah-rah for the vaccines.
Is there a similar effort underway to get more people or organizations to actually link to the studies in question (as was done here)? You'd think this would be more prevalent in the internet age, but sadly no.
This would be OK if the teachers also carefully pointed out EBM failures, limitations, pernicious influence of funders, and the questionable or contestable aspects of many RCTs.
Another, more down-to-earth problem is that in the real world, few schoolkids and teens - even the bright ones - will be truly interested or will remember much.
I'm definitely not going to subscribe to this substack.
Yikes. I agree it's imperative to improve health literacy and critical thinking skills but why use this one study on hydroxychloroquine as the example? Researchers have known since SARS-1 that it was an effective treatment. This has been buttressed by reliable studies, meta analyses. We also know - like ivermectin - that it's proven to be a safe medicine and causes v. few adverse side effects unlike the drugs approved to treat Covid-19 not to mention the so-called vaccines. So even if - in the end - it's not as effective as we might hope it won't hurt patients if prescribed early and at the correct doses.... Why not use the flawed Pfizer clinical trials on the mRNA injectables to improve health literacy instead? Talk about a doozy.
I would be more um "optimistic" if the doctors had chosen a big pharma study. If you're going to teach kids to think critically, choose a study on something you believe is effective.