Humans have a long-standing issue comprehending risk. We need look no further than the many monuments to our struggle of risk and reward estimation rising from the desert on the strip in Las Vegas.
While the stakes of a financial gamble are obvious, when it comes to understanding health risks the challenge is even greater. Not unlike Vegas, a number of parties with financial interest tied to our health-related actions further cloud our ability to understand risk.
One of the most common headlines we see splattered over social media, scrolling across our TV screens, or at the top of the newspaper is something along the lines of “X behavior causes Y disease” or “Z treatment effective to treat Y disease.” While the economy of words doesn’t allow a headline to tell a whole story, these types of claims often border on half-truth at best, and are downright misleading at worst.
The truth is that health information based on scientific evidence can hardly ever be so broadly applied. There are a number of controversial examples that can be used, but to keep emotion out of it let’s stick to something not so politically charged.
Selenium has long been studied with respect to its influence on thyroid function. A click-worthy headline such as “Selenium intake linked to better thyroid function” would be fairly typical to see. And while there is likely some truth to that statement, it really doesn’t capture what associated studies conclude.
Did the study address selenium status in the population in question? Are there other factors that influence how successful adequate selenium intake would be? Is Selenium helpful for both individuals with underactive and overactive thyroid issues? Is benefit seen in individuals of all ages?
A more accurate headline summarizing a recent study might look like this: “Selenium supplementation in hypothyroid patients taking hormone replacement improved markers of auto-immune thyroiditis and subjective quality of life scores”. Now that headline is much more accurate – but it sure isn’t click-worthy.
It turns out research can be complicated. So how do we assign a risk or reward value based on scientific research? The issue is far from black and white.
Based on our example, if I take selenium, will my thyroid function improve, and is there any risk involved? Unfortunately there is no easy answer.
Statistical measures like Number Needed to Treat (NNT), Odds Ratios (OR), and Relative Risk (RR) can be helpful … if you’ve taken a few high-level statistics courses, but there really isn’t any green light/red light measure for most preventative or treatment approaches to health issues.
Science is nuanced, uncertain, and depends greatly on application and interpretation. Any claim that it is otherwise should be greatly scrutinized.
It is important to remember that the conclusion we draw from most health-related science, while often considered conclusive and final, really reflects changes in risk and reward.
When choosing to undergo treatment, make lifestyle changes or add a new intervention to your daily routine, don’t be afraid to ask questions. Ask how your risk will change, and take inventory of your own tolerance or risk aversion.
Be an informed health consumer, and always ask if your resources are more interested in your wallet than your wellness.