Sunnybrook Staff / en Caution needed when drawing links between improving symptoms and unproven remedies: Study /news/caution-needed-when-drawing-links-between-improving-symptoms-and-unproven-remedies-study <span class="field field--name-title field--type-string field--label-hidden">Caution needed when drawing links between improving symptoms and unproven remedies: Study </span> <div class="field field--name-field-featured-picture field--type-image field--label-hidden field__item"> <img loading="eager" srcset="/sites/default/files/styles/news_banner_370/public/2024-09/GettyImages-1481433552-crop.jpg?h=1f3480b4&amp;itok=5u4uz5K5 370w, /sites/default/files/styles/news_banner_740/public/2024-09/GettyImages-1481433552-crop.jpg?h=1f3480b4&amp;itok=_YKv15oC 740w, /sites/default/files/styles/news_banner_1110/public/2024-09/GettyImages-1481433552-crop.jpg?h=1f3480b4&amp;itok=j9VhcB__ 1110w" sizes="(min-width:1200px) 1110px, (max-width: 1199px) 80vw, (max-width: 767px) 90vw, (max-width: 575px) 95vw" width="740" height="494" src="/sites/default/files/styles/news_banner_370/public/2024-09/GettyImages-1481433552-crop.jpg?h=1f3480b4&amp;itok=5u4uz5K5" alt="a person mixes various liquid ingredients into a bottle"> </div> <span class="field field--name-uid field--type-entity-reference field--label-hidden"><span>Christopher.Sorensen</span></span> <span class="field field--name-created field--type-created field--label-hidden"><time datetime="2024-09-06T12:03:17-04:00" title="Friday, September 6, 2024 - 12:03" class="datetime">Fri, 09/06/2024 - 12:03</time> </span> <div class="clearfix text-formatted field field--name-field-cutline-long field--type-text-long field--label-above"> <div class="field__label">Cutline</div> <div class="field__item"><p><em>(photo by&nbsp;Oleksandra Yagello/Getty Images)</em></p> </div> </div> <div class="field field--name-field-author-reporters field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/news/authors-reporters/sunnybrook-staff" hreflang="en">Sunnybrook Staff</a></div> </div> <div class="field field--name-field-topic field--type-entity-reference field--label-above"> <div class="field__label">Topic</div> <div class="field__item"><a href="/news/topics/breaking-research" hreflang="en">Breaking Research</a></div> </div> <div class="field field--name-field-story-tags field--type-entity-reference field--label-hidden field__items"> <div class="field__item"><a href="/taxonomy/term/6923" hreflang="en">Sunnybrook Health Sciences Centre</a></div> <div class="field__item"><a href="/news/tags/temerty-faculty-medicine" hreflang="en">Temerty Faculty of Medicine</a></div> <div class="field__item"><a href="/news/tags/institute-health-policy-management-and-evaluation" hreflang="en">Institute of Health Policy Management and Evaluation</a></div> <div class="field__item"><a href="/news/tags/dalla-lana-school-public-health" hreflang="en">Dalla Lana School of Public Health</a></div> <div class="field__item"><a href="/news/tags/research-innovation" hreflang="en">Research &amp; Innovation</a></div> </div> <div class="field field--name-field-subheadline field--type-string-long field--label-above"> <div class="field__label">Subheadline</div> <div class="field__item">"Post-hoc bias can play tricks on patients that can eventually lead to serious disappointments –&nbsp;and for health-care workers, it can ultimately lead to shortfalls in care"</div> </div> <div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p>People&nbsp;tend to continue with unproven treatments even if there’s no evidence to suggest an initial marginal improvement in symptoms is anything more than a potential coincidence, a new study has found.</p> <p>"I've noticed many of my patients take unnecessary vitamins, pills or alternative remedies with little evidence to inform their choice, leading to a lot of distraction, wishful thinking and wasted money,” says senior study author&nbsp;<strong>Donald Redelmeier</strong>, a staff internist and senior scientist at&nbsp;Sunnybrook Health Sciences Centre, and professor in the department of medicine in the ߲ݴý’s Temerty Faculty of Medicine.</p> <p>“Perhaps even more concerning is a false belief that leads to a missed diagnosis that later becomes incurable.”&nbsp;</p> <p>The study, <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823147">published in the journal&nbsp;<em>JAMA Network Open</em></a>, explores “post-hoc bias” – a tendency in reasoning that causes many patients to continue taking dubious or unreliable treatments. The bias encourages a popular misconception: that because one action preceded another later event, the first must have caused the second since it occurred in sequence.</p> <p>But medical science, the researchers note, stresses that the order of two events does not prove a cause-and-effect since coincidences are frequent. The implication for medical care is that a patient who improved after a treatment is not necessarily a patient who improved because of the treatment.</p> <p>Instead, other potential explanations include withdrawal from an adverse activity, added rest or the body’s own healing powers.</p> <p>To test bias across a variety of clinical cases, the researchers ran multiple experiments using hypothetical clinical scenarios administered by a randomized survey of pharmacists and members of the community.</p> <p>The scenarios described a patient with fatigue or another vague symptom who feels a bit better after trying a vitamin, shampoo, sugar pill or other treatment.</p> <p>“We found that most respondents suggested continuing the treatment indefinitely even though the change in symptoms might be pure random chance," says Redelmeier, who is also affiliated ICES and the&nbsp;Institute for Health Policy, Management and Evaluation&nbsp;in U of T’s Dalla Lana School of Public Health.</p> <p>"The post-hoc bias can play tricks on patients that can eventually lead to serious disappointments –&nbsp;and for health-care workers, it can ultimately lead to shortfalls in care."</p> <p>While attributing an initial improvement in – or lack of – symptoms to a treatment is a quick and intuitive approach, the researchers say the study reinforces the need for both patients and clinicians to be cautious when drawing conclusions.</p> <p>“An awareness of post-hoc bias will not make it disappear, however we suggest patients and clinicians need to think twice and stay mindful of alternative explanations.”</p> <p>The study was supported by the Alfred P. Sloan Foundation, a Canada Research Chair in Medical Decision Sciences, Canadian Institutes of Health Research, the PSI Foundation of Ontario and the National Science Foundation.</p> <p><em>This story was <a href="https://sunnybrook.ca/research/media/item.asp?c=2&amp;i=3744&amp;f=scientists-caution-against-hasty-conclusions-for-alternative-remedies" target="_blank">originally posted</a> at Sunnybrook Research Institute</em></p> </div> <div class="field field--name-field-news-home-page-banner field--type-boolean field--label-above"> <div class="field__label">News home page banner</div> <div class="field__item">Off</div> </div> Fri, 06 Sep 2024 16:03:17 +0000 Christopher.Sorensen 309291 at