Women's Health Base

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Posts Tagged ‘Women’s Health’

How to read a scientific paper on women in 7 easy steps

Posted by hannahflynn on May 2, 2009

The column inches given over to the latest research on why women should not drink during pregnancy is only the tip of the iceberg. In recent months I have seen the columns of both the mainstream media and scientific journals filled with diverse claims about the effect mothers have on their sons, daughters and society in general ranging from the tenuous to the ridiculous.

This has obviously led to a great deal of confusion for journalists, women and obviously mothers. The murky waters of peer-reviewed research can appear an impenetrable forest to the uninitiated, but by following these steps you should be able to make your mind up for yourselves.

 1)      Is it peer reviewed?

The recent scandal involving Merck’s payments to Elsevier to produce publications which looked like peer reviewed journals, but did in fact only publish research showing positive results for the effectiveness of the company’s product, has highlighted the importance of this. Peer review involves the paper being sent to working scientists in the relevant field who will assess the significance of the findings and decide whether the paper warrants publication. They will come to this decision based on whether the findings are original (they have not been published before), reproducible (the experiments be done again and achieve the same results) and significant (the finding is worthy of attention from other scientists in the field).

 2)      What questions are they asking?

This is a very significant question with regards to gender based research. Is the question the right question to be asking in the first place? For example, a lot of research has been done into the effect of drinking in pregnancy on a foetus. This is due to the existence of a syndrome known as Foetal Alcohol Syndrome which can result in low birth weight offspring in alcoholic mothers who abused alcohol during pregnancy. However, these papers rarely look at the effect of very low alcohol consumption in pregnant mothers; a far more significant question for the vast majority of mothers to be. The reason this has not been done is the effects of low alcohol consumption would be far harder to measure.

3)      How big is the sample?

The MMR scare started after a paper with a sample size of 12was publishedin the Lancet. It is impossible to establish a significant result with this sample size, simply because the margin of error would be so large no trend could not be established, meaning any causal link implied would be meaningless.

 A good sample size will depend on what is being looked at. Any trial regarding diet or lifestyle will require a large sample as the variables are so large. A trial looking at a rare disease may have to have a smaller sample size because of the availability of subjects. However, the bigger the sample the smaller the margin of error so the stronger the data.

4)      What are the variables?

The simplest variable is gender. Are the groups, particularly in diet or lifestyle research, divided into gender? This is important as men and women have different metabolisms. It is impossible to eliminate all variables in any biological research as you are working with living organisms. However, it is possible to take all variables into account when planning the methodology and deciding conclusions. A well written experiment will explain how the groups in the trial are sampled, taking into account any variations. Variations which can not be controlled will be referred to in the conclusion as a possible source of error. Natural variation in a sample group need not result in inconclusive data, but if ignored then the whole experiment or trial is based on weak assumptions at best.

 5)      How quantifiable is what they are measuring?

Birth weight, genetic disease and death are all easily quantifiable results which can be used to produce meaning full conclusions. Often problems like ‘learning difficulties’, ‘problems bonding’ and ‘low satisfaction’ are not well defined in papers and can lead the conclusions which may mislead. A good paper should have quantified these in the methodology of the paper, for example learning difficulties could mean something quantifiable like a diagnosed dyslexic.

 6)      Are the results significant?

This is the area that is the most difficult to understand if you do not have a scientific or statistical background. I will try to explain the most commonly used statistic, the p value, to explain significance.

When looking at data from a piece of biological research it is important to calculate what the probability is that the results you have may have happened by chance. If your results are not caused by chance then you have a significant result. This probability is currently set at 5 percent, or p = 0.05. If there is less than a 5 percent chance your data was caused by chance you can claim your date is significant and conclusions can be drawn that there is a causal link. (A good explanation for journalists can be found here.)

 7)      Does more research need to be done?

 If however p = 0.07 there is a 7 percent chance your results are caused by chance. This is not a high enough level of significance to base conclusions on but there is probably enough evidence to base further research in the area on.

 Similarly if the paper has a sample size which does not seem big enough, this does not mean the findings are completely null and void, rather more research needs to be done before conclusions can be drawn.

Extra reading:

For a more in depth analysis of statistics and other Bad Science, read Ben Goldacre’s blog and column in The Guardian. The comments left are often ripe ground for debate on how to interpret scientific papers.

For an irreverent but clear explanation of bad statistics turn to Feedback in New Scientist.

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5 of the best women’s health blogs

Posted by hannahflynn on April 5, 2009

Our Bodies our Blogs

A harsh critic of the Bush administration’s approach to women’s health, this blog could have lost its way once Obama came into office. However, it is as fierce and clever as ever, providing refreshing and informed criticism towards government policy, the medical establishment and the media. They ask the questions every woman doesn’t realise she needs to.

Dr Petra Boyton

More’sagony aunt is increasingly becoming an important but critical commentator on women’s health in the British media. Ben Goldacre is a fan of this psychologist, so get on board. A nice bit of brain food on the side of position of the fortnight, and I think she’s going to become every thinking girl’s favourite.

The Optimum Population Trust

Yes, sometimes it talks about chickens and cows, but this scientific and political site does mainly look at the way human reproduction works…and how it affects the planet. With a wide range of sources, the news it reports on it varied and exciting.

In Rude Health

A comprehensive if naive look at women’s health in the media and brilliantly written. Its author is a professional journalist who writes books looking at the fruitier side of couple’s health, hence the ‘rude’ in the title.

Scarleteen

If anything is going to make you happy to be a woman in Europe its this blog. More of a social enterprise than a news source this, website provides information and campaigns for sex education in the United States.

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Seven states to sue over ‘conscience rule’

Posted by hannahflynn on January 19, 2009

Just days before Barack comes to save us all (most importantly women according to the National Women’s Law Centre) it has been announced that seven states, Planned Parenthood Federation of America and the American Civil Liberties Union are suing as the ‘conscience rule’ clashes with state laws.

In Connecticut state law requires all hospitals in the state to provide emergency contraception to rape victims. Not asking much you may think, but dispensers who claim providing the morning-after-pill goes against their conscience can refuse to prescribe it.

“This rule protects the right of medical providers to care for their patients in accord with their conscience,” HHS Secretary Michael O. Leavitt said when the final rule was announced.

The ‘conscience rule’ should come into force tommorow the day of Barack Obama’s inaugration, and he has voiced opposition to the amendment.

However, opposition has been venomous since the 11th hour amendment was announced last month, seen by many as a last, unwelcome push by the on-the-way-out Bush administration.

Commentators also predict the ruling will affect poor women the most.  

It allows funding to be cut to hospitals where individuals are coerced into providing the morning-after-pill, known in the United States as Plan B, against their conscience.

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Tamoxifen: Wonder Drug if Taken Properly

Posted by hannahflynn on November 16, 2008

Cardiff’s own have managed to reveal the genetic cause of tamoxifen resistance in women, using a rare cell-line produced by the University. They have also clarified the mechanism by which the cancer-drug works.

While tamoxifen has been understood to be an oestrogen blocker for a number of years, the work done by the team at the Welsh School of Pharmacy showed which genes tamoxifen affects. It was found that ErbB2 must be ‘switched-off’ by tamoxifen in order to prevent recurrence of breast cancer, using a control switch “in the background of the genome“. This is held in position by signalling molecule Pax2. Results have been published in Nature.

The results have come not long after the revelation that many breast cancer patients are not taking tamoxifen properly or even completing the course, significantly increasing the risk of recurrence. Reasons cited include the suggestion that patients put less emphasis on taking a tablet than they would on chemotherapy. Published in the British Journal of Cancer  the paper has received surprisingly little press attention with only B2Bs like Nursing Times and Healthcare Republic giving it any space.  

Interestingly, The Western Mail not too long ago speculated that at-risk women may be given tamoxifen as a preventative measure. Trials are still ongoing, alongside another trial by IBIS who are looking at ways to prevent breast cancer.

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Pop the Champagne Corks – 9 Months Early

Posted by hannahflynn on November 11, 2008

Good news for women wishing to sample the Chardonnay without being shot down by the PC-pregnancy brigade, drinking in pregnancy is now good for you!

After a report a few years ago claimed it was impossible to measure the minimum amount of alcohol that could cause Foetal Alcohol Syndrome, many countries recommended tee-total pregnancies.

The health scare saw the introduction of warnings on alcoholic drinks that told women to avoid alcohol if pregnant or even just trying to conceive.

Women who drank 2 units a week (one glass of wine) during pregnancy were found in the latest research to be calmer during pregnancy and had children that did better in cognitive tests.

There is some concern that the results are slightly skewed by the strong correlation between light drinking in pregnancy and social class, but Fred Brooksteing, Professor of Statistics at Washington University said, “We have no evidence that it (light drinking) does anything and it probably makes women feel better”

Yvonne Kelly who ran the lab at UCl that worked on the paper said the most beneficial effect of light drinking durring pregnancy was the calming effect it had on mothers-to-be, making pregnancies less stressful.

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