Chapter 2. Putting Risk in Perspective

    1.
    Woloshin Steven, Schwartz Lisa, Welch H Gilbert. Risk Charts: Putting Cancer in Context. Journal of the National Cancer Institute. 2002;94:799–804. available at http://jnci​.oxfordjournals​.org/cgi/reprint/94/11/799. [PubMed: 12048267]
    2.
    Woloshin Steven, Schwartz Lisa, Welch H Gilbert. The Risk of Death by Age, Sex, and Smoking Status in the United States: Putting Health Risks in Context. Journal of the National Cancer Institute. 2008;100:845–853. available at www​.vaoutcomes.org/books.php. [PMC free article: PMC3298961] [PubMed: 18544745]

    Chapter 4. Judging the Benefit of a Health Intervention

    1.
    Pederson TR. Randomised Trial of Cholesterol Lowering in 4444 Patients with Coronary Heart Disease: The Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383–1389. [PubMed: 7968073]
    2.
    You may be wondering why the risk of heart attack death in the placebo group in the Zocor study, which included people age 35 to 70, is so high: 8.5% (85 per 1,000 people) over 5 years. According to the risk charts, the 10 year risk of heart disease death doesn't reach that level for men until age 70, and for women until age 75. The explanation is simple. The risk charts show the average risk for people at each age. But the people in the Zocor study were not “average.” They all were high risk for heart disease death because they had already had one prior heart attack. This highlights the importance of knowing whom health statistics are based on: characteristics like age, gender, and, in this case, health conditions powerfully influence risk.
    3.
    Schwartz Lisa, Woloshin Steven, Dvorin Evan, Welch H Gilbert. Ratio Measures in Leading Medical Journals: Structured Review of Accessibility of Underlying Absolute Risks. British Medical Journal. 2006;333:1248–1250. available at www​.vaoutcomes.org/books.php. [PMC free article: PMC1702463] [PubMed: 17060338]
    4.
    Woloshin Steven, Schwartz Lisa. Press Releases: Translating Research into News. Journal of the American Medical Association. 2002;287:2856–2858. available at www​.vaoutcomes.org/books.php. [PubMed: 12038933]
    5.
    Woloshin Steven, Schwartz Lisa. Media Reporting on Scientific Meeting Presentations: More Caution Needed. Medical Journal of Australia. 2006;184:576–580. available at https://www​.mja.com.au​/public/issues/184_11_050606​/woll0024_fm.pdf; [PubMed: 16768666]
    Schwartz Lisa, Woloshin Steven. News Media Coverage of Screening Mammography for Women in Their 40s and Tamoxifen for Primary Prevention of Breast Cancer. Journal of the American Medical Association. 2002;287:3136–3142. available at www​.vaoutcomes.org/books.php; [PubMed: 12069679]
    Moynihan Ray, Bero Lisa, Ross-Degnan Dennis, Henry David, Lee Kirby, Watkins Judy, Mah Connie, Soumerai Stephen. Coverage by the Media of the Benefits and Risks of Medications. New England Journal of Medicine. 2000;342:1645–1650. [PubMed: 10833211]
    Cassels Alan, Hughes Merrilee, Cole Carol, Mintzes Barbara, Lexchin Joel, McCormack James. Drugs in the News: An Analysis of Canadian Newspaper Coverage of New Prescription Drugs. Canadian Medical Journal. 2003;168:1133–1137. [PMC free article: PMC153682] [PubMed: 12719316]
    6.
    Woloshin Steven, Schwartz Lisa, Tremmel Jennifer, Welch H Gilbert. Direct to Consumer Drug Advertisements: What Are Americans Being Sold? Lancet. 2001;358:1141–1146. available at www​.vaoutcomes.org/books.php; [PubMed: 11597668]
    Bell Robert, Wilkes Michael, Kravitz Richard. The Educational Value of Consumer-Targeted Prescription Drug Advertising. Journal of Family Practice. 2000;49:1092–1098. [PubMed: 11132058]

    Chapter 5. Not All Benefits Are Equal

    1.
    Writing Group for the Women’s Health Initiative Investigators. Risks and Benefits of Estrogen plus Progestin in Healthy Postmenopausal Women: Principal Results from the Women’s Health Initiative Randomized Controlled Trial. Journal of the American Medical Association. 2002;288:321–333. [PubMed: 12117397]
    2.
    Bogan Richard, Fry June, Schmidt Markus, Carson Stanley, Ritchie Sally. for the TREAT RLS US (Therapy with Ropinirole Efficacy and Tolerability in RLS US) Study Group. Mayo Clinic Proceedings. 2006;81:17–27. [PubMed: 16438474]

    Chapter 6. Consider the Downsides

    1.
    Krystal Andrew, Walsh James, Laska Eugene, Caron Judy, Amato David, Wessel Thomas, Roth Thomas. Sustained Efficacy of Eszopiclone over 6 Months of Nightly Treatment: Results of a Randomized, Double-Blind, Placebo-Controlled Study in Adults with Chronic Insomnia. Sleep. 2003 26:793–799. [PubMed: 14655910]
    2.
    Table data taken from Krystal et al., “Sustained Efficacy of Eszopiclone.”
    3.
    Fisher Bernard, Costantino Joseph P, Wickerham D Lawrence, Redmond Carol K, Kavanah Maureen, Cronin Walter M, Vogel Victor, Robidoux André, Dimitrov Nikolay, Atkins James, Daly Mary, Wieand Samuel, Tan-Chiu Elizabeth, Ford Leslie, Wolmark Norman. other National Surgical Adjuvant Breast and Bowel Project investigators. Tamoxifen for Prevention of Breast Cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. Journal of the National Cancer Institute. 1998;90:1371–1388. [PubMed: 9747868]

    Chapter 7. Do the Benefits Outweigh the Downsides?

    1.
    Krystal Andrew, Walsh James, Laska Eugene, Caron Judy, Amato David, Wessel Thomas, Roth Thomas. Sustained Efficacy of Eszopiclone over 6 Months of Nightly Treatment: Results of a Randomized, Double-Blind, Placebo-Controlled Study in Adults with Chronic Insomnia. Sleep. 2003;26:793–799. [PubMed: 14655910]
    2.
    Fisher Bernard, Costantino Joseph P, Wickerham D Lawrence, Redmond Carol K, Kavanah Maureen, Cronin Walter M, Vogel Victor, Robidoux Andre, Dimitrov Nikolay, Atkins James, Daly Mary, Wieand Samuel, Tan-Chiu Elizabeth, Ford Leslie, Wolmark Norman other National Surgical Adjuvant Breast and Bowel Project investigators. Tamoxifen for Prevention of Breast Cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. Journal of the National Cancer Institute. 1998;90:1371–1388. [Google Scholar] In the table shown in the chapter 7 text, 5-year risks were calculated from the annual rates presented in this article.

    Chapter 8. Beware of Exaggerated Importance

    1.
    Maugh Thomas. Study Calls for Routine CT Scans for Smokers; Imaging Can Detect Lung Cancer Early, Boosting Survival Rates. But Some Experts Say More Research Is Needed. Los Angeles Times. 2006 October 26:A18.
    2.
    Marcus Pamela, Bergstralh Erik, Fagerstrom Richard, Williams David, Fontana Robert, Taylor William, Prorok Phillip. Lung Cancer Mortality in the Mayo Lung Project: Impact of Extended Follow-Up. Journal of the National Cancer Institute. 2000;92:1308–1316. [PubMed: 10944552]
    3.
    Welch H Gilbert, Schwartz Lisa, Woloshin Steven. Are Increasing 5-Year Survival Rates Evidence of Progress against Cancer? Journal of the American Medical Association. 2000;283:2975–2978. available at www​.vaoutcomes.org/books.php. [PubMed: 10865276]
    4.
    Ries LAG, Kosary CL, Hankey BF, Miller BA, Clegg L, Edwards BK, editors. SEER Cancer Statistics Review, 1973–1996. Bethesda, Md.: National Cancer Institute; 1999. available at http://seer​.cancer.gov​/csr/1973_1996/index.html (1950 data available in the Overview document);
    Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, Mariotto A, Miller BA, Feuer EJ, Altekruse SF, Lewis DR, Clegg L, Eisner MP, Reichman M, Edwards BK, editors. SEER Cancer Statistics Review, 1975–2005. Bethesda, Md.: National Cancer Institute; available at http://seer​.cancer.gov/csr/1975_2005/, based on November 2007 SEER data submission, posted to the SEER website, 2008.
    5.
    SEER (Surveillance, Epidemiology, and End Results) stage-specific survival rates (and other cancer statistics) are available at http://seer​.cancer.gov​/cgi-bin/csr/1975_2004/search.pl.
    6.
    See also Welch H Gilbert, Woloshin Steven, Schwartz Lisa How Two Studies on Cancer Screening Led to Two Results. New York Times. 2007 March 13 F5, F8, available at www​.nytimes.com/2007​/03/13/health/13lung.html; [Google Scholar] Welch H Gilbert, Woloshin Steven, Schwartz Lisa, Gordis Leon, Gotzsche Peter, Harris Russell, Kramer Barnett, Ransonhoff David Overstating the Evidence for Lung Cancer Screening: The I-ELCAP Study. Archives of Internal Medicine. 2007;167:1–7. available at http://archinte​.ama-assn​.org/cgi/content/full/l67/21/2289. [Google Scholar]

    Chapter 9. Beware of Exaggerated Certainty

    1.
    Hackam Daniel G, Redelmeier Donald. Translation of Research Evidence from Animals to Humans. Journal of the American Medical Association. 2006;296:1731–1732. [PubMed: 17032985]
    2.
    Schwartz Lisa, Woloshin Steven, Welch H Gilbert. Can Patients Interpret Health Information? An Assessment of the Medical Data Interpretation Test. Medical Decision Making. 2005;25:290–300. available at www​.vaoutcomes.org/books.php. [PubMed: 15951456]
    3.
    Woloshin Steven, Schwartz Lisa, Welch H Gilbert. The Effectiveness of a Primer to Help People Understand Risk: Two Randomized Trials in Distinct Populations. Annals of Internal Medicine. 2007;146(no. 4):256–265. available at www.annals.org/cgi/content/full/14 6/4/256. [PubMed: 17310049]
    4.
    To learn more about research design and the importance of randomized trials, see Evans Imogen, Thornton Hazel, Chalmers Iain Testing Treatments: Better Research for Better Healthcare. London: British Library; 2006. [Google Scholar]
    5.
    Schwartz Lisa, Woloshin Steven, Baczek Linda. Media Coverage of Scientific Meetings: Too Much, Too Soon? Journal of the American Medical Association. 2002;287:2859–2863. available at www​.vaoutcomes.org/books.php. [PubMed: 12038934]
    6.
    Lasser Karen, Allen Paul, Woolhandler Steffie, Himmelstein David, Wolfe Sidney, Bor David. Timing of New Black Box Warnings and Withdrawals for Prescription Medications. Journal of the American Medical Association. 2002;287:2215–2220. [PubMed: 11980521]

    Chapter 10. Who’s Behind the Numbers?

    1.
    Bekelman Justin, Li Yan, Gross Cary. Scope and Impact of Financial Conflicts of Interest in Biomedical Research: A Systematic Review. Journal of the American Medical Association. 2003;289:454–465. [PubMed: 12533125]
    2.
    Welch H Gilbert, Mogielnicki Juliana. Presumed Benefit: Lessons from the American Experience with Marrow Transplantation for Breast Cancer. British Medical Journal. 2002;324:1088–1092. available at www​.pubmedcentral.nih​.gov/articlerender.fcgi?artid=1123033. [PMC free article: PMC1123033] [PubMed: 11991918]
    3.
    Schwartz Lisa, Woloshin Steven. The Case for Letting Information Speak for Itself. Effective Clinical Practice. 2001;4:76–79. available at www​.vaoutcomes.org/books.php. [PubMed: 11329989]
    4.
    The National Library of Medicine’s indexes of the medical literature are available at www​.ncbi.nlm.nih.gov/PubMed.
    5.
    The federal government’s registry of clinical trials (ClinicalTrials​.gov) lists federally and privately supported clinical trials conducted in the United States and around the world, and includes details about the study design and funding. It is available at www​.clinicaltrials.gov/ct2/search.
    6.
    The Integrity in Science Project tracks more than 200 science-based federal advisory committees for undisclosed conflicts of interest and monitors the media and scientific literature for failure to disclose conflicts. It is available at www​.cspinet.org/integrity.