Saturday, August 10, 2019

Medical "Studies"

The “medical study” with respect to caffeine use and migraines that was on the news a few days ago is a perfect example of why I pay no attention to “medical studies” in the news today.

The stated conclusion was that three cups of coffee per day (or less) would not trigger migraines, while four or more cups of coffee could. That conclusion was obviously bogus. Any neurologist who knows anything about migraines can tell you that caffeine is known to resolve migraine, and that the mechanism by which it does so is well documented. (It constricts blood vessels.)

That neurologist will also tell you that caffeine’s role in triggering migraines is not well known at all. There is anecdotal evidence that it might, as well as that more than a hundred other factors might, but there is no documentation of the mechanism whereby any of them, including caffeine, might do so.

Finally, that neurologist will tell you that in many patients with frequent and severe migraines, a majority actually, caffeine appears to play no role whatever in triggering migraines. I happen to be one of those patients.

Having read a conclusion which was at such obvious odds with medical reality, I went searching to see who performed the study and how they performed it. The result did not really surprise me. The description of the study began, “They asked patients who frequently experienced migraines to keep a diary for six weeks,” and went on to say that, “In all, 98 patients completed these diaries.”

This is the state of medical science in the US today. A “medical study” now consists of fewer than 100 untrained persons keeping notes for six weeks.

The number of ways in which this study are invalid are so numerous that it’s hard to know where to start. 1) The number of participants, 98, is several orders of magnitude too small to provide anything like meaningful results. 2) Lay persons notoriously keep highly inaccurate “diaries,” and relying upon them to determine meaningful medical conclusions is malpractice. 3) Six weeks is too short a period of time, again by several orders of magnitude, for any conclusion to be even remotely valid. 4) The juxtaposition of the so-called “trigger” and the onset of the migraine is highly variable, and yet no one questions the cause/effect relationship.

In other words, “I drank four cups of coffee in the morning, and late that afternoon I had a migraine.” If someone claimed that a truck hitting him in the morning was the cause of him falling down in the afternoon, his claim of cause and effect might be questioned.

Making the “study” even more nonsensical is that these diaries did not report the types of “caffeinated drinks” consumed, not differentiating between a 24oz Red Bull energy drink and a 6oz cup of green tea, so the “researchers” did not have the slightest idea of the amount of caffeine that was under consideration.

The great “health care debate” being held by the Democratic Party might be entirely moot, if this is the quality of the medical profession that is going to be providing the health care about which we are arguing.

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