Valid research essential in all aspects of health and healthcare

Throughout the healthcare system additional valid research is needed to ensure patients are safe and receiving optimal care.

Dr. John Ioannidis, Stanford Medicine, has recently challenged his peers’ misleading and simply wrong clinical research. And in fact, he claims that 80 percent of non-randomized studies and 25 percent of randomized studies are wrong.

And yet the standard of care remains based on these invalid studies.

Add this to the Institute of Medicine’s claim that only about half of medicine is based on valid science and it’s clear we have a great opportunity to significantly improve the healthcare paradigm and the care we provide to our communities.

SEE: Truth in healthcare: A moving target

160709 truth in healthcare

 

This is also true when it comes to Animal-Assisted Therapy …

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SEE: The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals

… in Current Gerontology and Geriatrics Research. 2014; 2014: 623203.
NCBI / US National Library of Medicine National Institutes of Health

Published online 2014 Nov 16. doi: 10.1155/2014/623203
E. Paul Cherniack and Ariella R. Cherniack

From the study:

Preliminary studies have suggested the potential benefits of animals on the physical and psychological health in humans.

Despite over four decades of research, these studies remain preliminary. They are compounded by methodologic problems including small sample size and lack of adequate controls and blinding.

Thus far, studies on the effects of animals on both mental and physical health have reported modest benefits.

Trials of animal-assisted therapy demonstrated improvements in behavioral symptom scores in small numbers of subjects of limited duration.

Investigations on the influence of animals on physical health, particularly epidemiological studies, that imply that the presence of animals can reduce cardiovascular risk, are more robust methodologically, but prospective trials demonstrating clinical benefit still need to be performed.

We can and must do better. From Truth in healthcare: A moving target:

  • First, we all must be open to new truths. We must replace ego and closed-minded thinking with open hearts and minds, while still maintaining scrupulous scientific rigor as we seek out new truths.
  • Second, we must acknowledge our biases. Bias does not go away. Be mindful of bias, acknowledge bias, and correct for bias. Put a light on the bias; don’t succumb to it.
  • Third, we must set an expectation that null data is as important as positive results and that a more complete picture of the truth is required. As Thomas Edison reportedly said, “I am not discouraged because every wrong attempt discarded is another step forward.” And in healthcare, every reported wrong research attempt may save lives and, most certainly, will save resources.
  • Fourth, we need more investment and focus in the T4 phase of translational research. T4 essentially bases research on the idea, “What is the best method to reach clinicians and patients alike with a nationwide policy concerning treatment X so that they, first, will understand the new treatment and second, start to use it?”
  • Fifth, we must better position clinicians to leverage this new wisdom with their individual patients. We must create a healing environment where the clinician is compensated appropriately for the time shared with each individual patient. We must create a healing environment where the patient is no longer simply a “fever chart, a cancerous growth, but a sick human being,” as per the Hippocratic Oath, where authentic connection, relationship, and trust lead to the patient telling the whole story, a better understanding of the patient’s truth, and clarity as to the appropriateness of a specific healing intervention for a specific patient.

 

The Institute of Medicine has identified six aims for improvement in care: Safe, Effective, Patient Centered, Timely, Efficient, and Equitable. To achieve these aims, it is imperative that we continuously find and refine the truth and efficiently get the truth to the front lines of the healthcare system … and yes this includes Animal-assisted therapy research.

Anything less is not good enough and will lead to harm to our patients, families, and communities … and also our animals.

Yes … we can do better.

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