The Tragic Consequences
Of Being Misled By
Health Outcomes Research

This page is as brief as we could make it. If you need more information on this topic, any intro to research book should be sufficient.

You can also do a search with a phrase like, "introduction to health outcomes research."

Health Outcomes Research

Of course what we mean by this is just the health results that follow some event, behavior or treatment.

For example, a study on on how effective prozac is on depression. A treatment is given (prozac) and scientists look at the outcome (has the depression improved?)

Research Debates Are Not For The Weak Of Heart

It may surprise you to know just how fierce the debates are in health research. There is an incredible amount of money and prestige riding on the results.

Researchers are just human beings who can get caught up in the emotions that swirl around them. Like us they too can be influenced by coworkers and money.

Just follow along and please understand that we can only touch on this issue. Still it should be informative.

Smoking Doesn't Cause Lung Cancer

That's right. No study has ever shown that smoking causes lung cancer, the Surgeon General's Warning be darned. The studies show a connection between smoking and cancer and any number of diseases, but in science, connection is not the same as causation. For example, someone could argue that people smoke because they are stressed out and it's the stress that causes cancer, not the cigarettes.

To prove causation, a researcher would have to set up an experiment that tests whether the "smoking group" was more likely to get lung cancer than the tea drinking group. The experiment, would have to go on for decades and include a lot of subjects, half of which would be forced to smoke, oh, let's say 2 packs a day for 25 years.

Thankfully, that kind of public research has never been done and can never be done due to moral reasons. Could you imagine the law suits?

This general problem with all research, not just health outcomes research, really shows the difficulty in isolating a cause and excluding other causes.

But we all know that if you smoke, you are much more likely to get lung cancer than if you don't smoke. The studies show a strong connection, we've all noticed how smokers have problems with their lungs, physiologists can explain how smoking leads to cell damage and that leads to lung cancer.

That's enough for me.

This issue of causation versus connection is one reason why there is controversy over whether dehydration or water contamination causes any number of diseases including cancer. There is no experiment that tests whether not drinking enough water or drinking contaminated water leads to disease. Such a study has never been done and can never be done for moral reasons.

Also, who would have interest in paying the millions of dollars the study would cost? Who could make money from advocating water as a cure for some condition? Experiments Are Never Long-Term

Many of our questions in research are about longterm effects of some treatment or behavior (water drinking and smoking are behaviors). We know that many bad things that we could do to ourselves (smoking) (or good things)take many years to show effects. Few teenagers get lung cancer.

The studies that follow subjects over many years are usually not set up to prove cause but rather connection. Like the studies on smoking.

This is especially important when looking at studies involving dehydration or water contamination. People don't get diseases at the first sign of dehydration or after drinking a glass of tap water. The effects often take years to show up.

This problem with health outcomes research has no real solution. Just be aware of it.

The placebo effect

The placebo effect is common and powerful. It is basically the tendency of research subjects to respond to a treatment as they believe they should respond.

Example: you are told that a certain pill will reduce your anxiety. If you are suggestible, even if you were just given a sugar pill, you would still truly believe that the pill worked, you really feel less anxious.

The placebo effect is a huge problem for researchers who are trying to figure out how a particular treatment effects a particular condition.

The Achilles heel problem

(Full disclosure. I just came up with this term for this particular research problem so forgive my arrogance.)

What I mean by this is simple.

When health outcomes research tests the effects of some treatment on some aspect of our health, it often looks at the connection between the treatment and some particular organ or capability or disease.

However, it is impossible to do good research on the effects of dehydration or of contaminated water. This is because, since we are mostly composed of water (75%) and water has a role in virtually every physical function, what end effect, organ or disease would a researcher choose to study as being affected by water intake or quality?

Our water level effects everything, so where would a researcher start?

Here's what I think.

If a researcher tried to statistically connect hydration to some condition, it would most likely not show a relationship.

Why?

Well, since water has so many roles in our bodies, the effect that dehydration may have on us could vary dramatically from person to person.

On one person, it would effect skin texture, on another person, cardiac functioning, for another it may effect two or more organs like the kidneys and liver.

The effects of dehydration would all depend on what our constitutional weak spot is. For me it was the blood pressure system.

That's why I think of this as the Achilles heel problem in health outcomes research.

Cheating Researchers

This is the most disturbing problem: researchers faking the findings. It figures, right?(Pardon my pun.) With all of the money and pressure that researchers feel to come up with certain results it is not surprising that a few bad apples would cheat.

The problem though is worse than a few bad apples. In the mid 90's the New York Times reported that 1 out of 3 studies that were conducted in college showed researchers cheated to show results they wanted to show.

Drug companies pay for research in which the results could cost or make them billions of dollars. Imagine the temptationto cheat. What we can't be sure of is just how often it occurs because the good cheaters are never caught.

Some state and federal employees have been shown to provide false information regarding the amount of contamination in public water supplies. Surely, they felt pressure to do so.

When the federal government asked for water quality reports from dozens of state officials, many did not submit reports, even years later.

Talking about not reporting, you should be aware that companies that pay for studies do not have to legally report the findings. That's right. A company could pay for a study and never reveal the results. It happens all the time in the drug industry and it's legal. What often happens is that the companies just pay for another study with another angle that theycould feel comfortable reporting.

This is not really cheating but it is not for the public good either.

Wouldn't it be good to have a rule that all research must be revealed to the public?

A Reasonable View Of Research

So with all of the problems with research, it may be tempting to discount all of it.

No, better to be aware of the issues and problems in research and take the research for what it is.

Research is still useful and makes a great contribution to society. Without research we would just have opinions and wishes.

It is understandable if you are confused about what research has really proven. So much research seems to conflict with other research

Remember when margarine was better for you than butter? No more.

And I can't seem to get this straight. Is coffee good for you or not?

Understand that research is never final. Questions are never really answered once and for all unless the answers are obvious.(The American Psychological Association once reported that people who lose a parent or spouse tend to feel depressed. No, duh.)

So some research may not be very useful or it may just cloud issues. But if a hundred studies show something is bad for you and the most recent study says that same thing is good for you, you have to wonder.

Studies usually don't tell you about long term effects. You have to consider this. So, there aren't any good long term studies on the health effects of dehydration or drinking contaminated water.

So, for many examples, you need to take the research that is available, even if it is incomplete. Then you need to ask yourself if it makes sense and can scientists explain how or why something causes some other thing.

That's what we do with the question of smoking and lung cancer.

It's also what we should do with questions about the importance of water for all of us.

It's quite obvious that water is extremely important to us. We need to drink enough to meet our needs.

It stands to reason that the water should be of good quality.

Many health workers have experience with patients that tells them how dangerous it is to be to be dehydrated.

Logically and scientifically, many writers could explain why drinking lots of healthy, clean water should be the first thing that we should do if we start to experience health problems or want to avoid them.

Finally, there are thousands of testimonials that point to the good effects of drinking more water. That is as good as research.

Don't take from this that simply drinking more clean water will solve everything because for reasons that this website discusses, it is not that simple.

But given the fact that we should drink water and that it seems to have a good effect on most people and there are no side effects and that it is free or cheap, shouldn't we make increased water intake the first line of defense if we experience a problem that water might solve?