Now comes yet another sobering reminder that lowering a surrogate marker doesn’t necessarily bring better health. On Feb. 6, the National Institutes of Health announced it was halting a key trial for diabetes. Researchers had hoped the trial, dubbed ACCORD (Action to Control Cardiovascular Risk in Diabetes), would show that more aggressive lowering of blood sugar would significantly reduce deaths. Instead, the opposite happened. More people in the intensive treatment group died than in the group getting standard care. “A thorough review of the data shows that the medical treatment strategy of intensively reducing blood sugar below current clinical guidelines causes harm in these…patients,” says Dr. Elizabeth Nabel, director of the National Heart, Lung & Blood Institute.
Scientific study often results in less than clear conclusions, especially in complex systems. There is great difficulty understanding what is actually going on, what interactions are present, what factors are significant, etc.. One of the great problems with the low level of scientific literacy in the USA is so many people think science is about simple absolute truth.
Scientific inquiry, especially related to health care, must attempt to gain insights from confusing signals. To gain scientific literacy one must understand basics concepts, like data is a proxy for what you aim to understand. To understand yourself you need to accept that science is not math. For a long time we are going to have to do our best to build up our understanding of human health (and other complex systems) as best we can. We need to be able to sort out what are solid conclusion, what are guesses, what seem like reasonable explanation and what level of confidence we can have in statements.
It is not enough to learn facts we need to be able to think scientifically and comprehend the subtleties surrounding the advances in scientific understanding. Some criticize newspapers and popular science for providing too simplistic a view of new scientific knowledge. While this can be a problem I really see the problem much more serious if people read obviously overly simplistic articles and don’t understand that it is just scratching the surface. The reader needs to take responsibility too. I enjoy many great articles that gloss over many of the details but provide a quick view of intriguing new breakthroughs.
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One one hand I think its great we have these studies to challenge our current perceptions. The study could be flawed in how it was executed which corrupts the data. Or could be we dont fully understand the role of blood sugar levels in our body as well as we thought. Nevertheless we need to keep plugging away at it