Narrator:
0:01
Welcome to MedEvidence, where we help you navigate the truth behind medical research with unbiased evidence, proven facts powered by ENCORE Research Group and hosted by cardiologist and top medical researcher Dr. Michael Koren.
Dr. Michael Koren:
0:16
My name is Dr. Michael Koren and I'm the host for today's session of MedEvidence and specifically our series Two Docs Talk and in this series myself and one of my colleagues get together and explore a medical topic together. And it's my great pleasure and privilege to welcome Dr. John Rowda to the program today. John and I have known each other for a very long time. We're colleagues at the ENCORE Research Group. John is an ophthalmologist and a tremendous clinical researcher. H e and I have worked together on a lot of projects in the past. But John has gotten really interested in informatics lately, which is the science of understanding how to get information, and John and I thought, wow, what a great topic to discuss on our MedEvidence broadcast, specifically, Two Docs Talk about how to look up things.
Dr. John Rowda:
1:06
Thank you for the introduction. Thank you for the kind introduction. And it's a very interesting subject. With too much information coming into our homes and computers, we hope to enlighten people, maybe teach you what we do.
Dr. Michael Koren:
1:20
Yes, you might want to start. I know we both love history and I think you told me about a Mark Twain quote. Maybe you'll share that with the audience, and that's a good place to start in terms of insight into how you get information and why it's important not only the information you get, but the process by which you get it.
Dr. John Rowda:
1:37
This is the exact quote I found. "The trouble with the world is not that people know too little, it's that they know so many things that just ain't so I love it.
Dr. Michael Koren:
1:51
I think that it speaks to the internet and the internet age that we live with, that there's so much information that comes at us. And one of the things that I like to ask our patients and my colleagues is where do you go for medical information? And it's interesting that I would say that 95% say I just Google it. So maybe you can kind of run through a little bit with the audience. What that means, when you just Google something. What process happens that will either give you a good result or maybe not such a good result?
Dr. John Rowda:
2:23
Well, there are several. We've been discussing this. First, you can ask a biased question, and then you get a biased result, and a couple that I thought of that are kind of benign but enlightening is to Google. You know, why is chocolate bad for your health, why is it good for your health, or research on chocolate and health, and you can do the same for coffee and look it up. What I recently learned was that if you have one source or a source that is biased, or you look up conspiracy theories, even if you ask an unbiased question because of your history, your computer is going to take you to a biased site. So it's very important to learn and vet your resources and the sources of the answers, not just the answer.
Dr. Michael Koren:
3:16
And that's really, really important. So our history of searching is saved, as we all know, and that actually influences the information that we get. And so it is this constant reinforcement of an idea, whether or not we actually believe the idea at first, or whether or not that idea is balanced with other equally good ideas. A nd a simple example that actually dawned on me probably about six months ago, I get a lot of news on MSN. com. A nd, I like them, in general, because they have articles that come from the left, they have articles that come from right so that I can hear all sides of arguments and different things.
Dr. Michael Koren:
3:59
But I was like commenting that they were having a lot of articles lately about the Beatles and I said, wow, isn't it interesting?
Dr. Michael Koren:
4:07
You wouldn't expect that people would want to know that much about the Beatles and was getting into why John Lennon wrote this song or why John Lennon and Paul McCartney had a fight about this or the other thing and getting into some of the details about their relationship. And I was scratching my head that you know why would people be that interested in it?
Dr. Michael Koren:
4:24
And then I realized that they thought that I was interested in it and they were pushing all this stuff to me because I happen to love music. I happen to love the Beatles and to love musical composition, and I happen understand why people do things in certain ways when they compose songs, and so obviously that became part of my profile and every day I was getting a new article about the rivalry, cooperation of John Lennon and Paul McCartney, and so there's obviously a lot of stuff out there, but this is what was being pushed to me, A nd, of course, just the fact that was pushed to me is gonna make me more likely to consume that, rather than learn about how hip-hop artists construct music which I'm also interested in or how classical music is making resurgence or whatever the case may be.
Dr. John Rowda:
5:12
So this selection bias is really super important and my contribution would be that we're biased. Everyone is biased. It just you have to understand your own bias and whatever source you go to. I f I like to read the Wall Street Journal, even health issues, they are gonna talk about how it's affecting business or harming business. That's what they care about, right? I think my personal bias is that I liked public health, the greater public health of the nation and my patients particularly. That's what I'm interested in and so that's my personal bias. I want both the healthiest patients and the healthiest nation.
Dr. Michael Koren:
5:52
All right, and we'll talk a little bit more about this. But we both spent a lot of time doing clinical trials and interested in clinical trials, and one of the key elements of clinical trials is that we work very hard to eliminate biases as best we can and to create a structured experiment that becomes an answer box. So People always want answers, but the fact is that we don't know the answers for everything. A nd it's nice that we have this, this environment that we work in, called the clinical trials industry, in which we can actually ask a health care question and then come up with an unbiased answer. B ecause the hypothesis is put out there and then we blind everybody, so we don't know who's on what and therefore the information comes in and it's not or I should say less subject to biases then another bias, that our own personal bias is very, very strong.
Dr. John Rowda:
6:46
For our personal experience, you can have a study of thousands of people led by world-renowned experts and scientists, but if that result doesn't match what's happening in our family, we doubt it and often go just with our personal five friends how they responded to a treatment or a program. And that's very hard to overcome. You have to be a very highly trained scientist to be able to push that aside.
Dr. Michael Koren:
7:09
Yeah, and the other major issue that we deal with is recency bias. So it's sometimes very natural to think that what's happened recently is more likely to happen again, rather than looking at things over the cycle of time. And understanding cycles of time are extremely important in terms of good decision-making, and you see it all the time. In the stock market, for example, we know of certain things that have held up because of the course of time. F or example, when the Fed raises interest rates, that tends to lead to poor stock market performance and vice versa. But often in the very short run, in the last days or weeks, we make judgments based on that and then seem surprised when things change a month down the road. When in fact, over the course of time, it's not a surprise at all.
Dr. John Rowda:
7:56
I've read Warren Buffett famously made a bet against four hedge funds that if he took the S&P 500 for 10 years and they did their day trading and all these fancy moves in the stock market that he would win. and the research shows he would, and he did. He beat four hedge funds just using an index S&P 500. Beautiful I love it.
Dr. Michael Koren:
8:21
So one of our goals and it's listed on our coffee cup here is to find the truth behind the data. And so this is as you know, the MedE vidence program, and we're all about exploring the truth, and the truth is not a straight line. The truth moves in and out. She hides in the weeds sometimes and you have to bring her out, but it's eventually there if you work hard enough.
Dr. John Rowda:
8:49
And you don't look for a hundred percent agreement among experts. That confuses people also. You're looking for a consensus. There's always going to be an outlier, maybe even a small, significant percentage. You don't agree. You have to go with the majority of evidence.
Dr. Michael Koren:
9:04
Absolutely, and we're going to talk about this in our next section, when we get into some more specifics about things that are controversial and where the truth may lie.
Narrator:
9:15
Thanks for joining the MedEvidence podcast. To learn more, head over to MedEvidence. com or subscribe to our podcast on your favorite podcast platform.
