{"version":"1.0","provider_name":"The Ethical Nag","provider_url":"http:\/\/ethicalnag.org","author_name":"Carolyn Thomas","author_url":"https:\/\/ethicalnag.org\/author\/czthomas\/","title":"Nagging 101","type":"link","html":"<p style=\"text-align:center;\"><a href=\"http:\/\/carolynthomas.files.wordpress.com\/2009\/09\/textbooks3.jpg\"><img data-attachment-id=\"5092\" data-permalink=\"https:\/\/ethicalnag.org\/nagging-101\/blue-ball-arrow-play\/\" data-orig-file=\"https:\/\/carolynthomas.files.wordpress.com\/2009\/09\/blue-ball-arrow-play.jpg\" data-orig-size=\"200,200\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;}\" data-image-title=\"blue-ball-arrow-play\" data-image-description=\"\" data-medium-file=\"https:\/\/carolynthomas.files.wordpress.com\/2009\/09\/blue-ball-arrow-play.jpg?w=200\" data-large-file=\"https:\/\/carolynthomas.files.wordpress.com\/2009\/09\/blue-ball-arrow-play.jpg?w=200\" class=\"aligncenter size-full wp-image-5092\" title=\"\" src=\"https:\/\/carolynthomas.files.wordpress.com\/2009\/09\/blue-ball-arrow-play.jpg?w=200&#038;h=200\" alt=\"\" width=\"200\" height=\"200\" srcset=\"https:\/\/carolynthomas.files.wordpress.com\/2009\/09\/blue-ball-arrow-play.jpg 200w, https:\/\/carolynthomas.files.wordpress.com\/2009\/09\/blue-ball-arrow-play.jpg?w=175&amp;h=175 175w\" sizes=\"(max-width: 200px) 100vw, 200px\" \/><br \/>\n<\/a>A glossary of research and marketing terms to help you become a savvy Nag yourself:<\/p>\n<h1 style=\"text-align:center;\"><span style=\"color:#993300;\"><strong><span style=\"color:#0066ff;\">TYPES OF RESEARCH<\/span><br \/>\n<\/strong><\/span><\/h1>\n<ul>\n<li style=\"text-align:left;\"><span style=\"color:#0000ff;\"><span style=\"color:#000000;\"><span style=\"color:#0066ff;\"><strong>Biomedical or basic research:<\/strong>\u00a0<\/span> studies done on<\/span> <\/span>cells, tissue or animals, often in a laboratory. They may or may not be relevant to humans. They often only suggest directions for research.<\/li>\n<li style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Epidemiological research:<\/strong>\u00a0<\/span> studies of groups of people (populations) to look at patterns in the rates, distribution, prevention and control of disease, injuries, and other health-related events.<\/li>\n<li style=\"text-align:left;\"><strong><span style=\"color:#0066ff;\">Social and behavioural research:<\/span><\/strong> studies that look at people\u2019s attitudes, needs and practices.<\/li>\n<li style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Clinical research:<\/strong>\u00a0<\/span> studies the diagnosis, treatment, prevention, and outcomes of diseases or conditions. They include intervention studies\u00a0 such as clinical trials and community-based trials that look at whether a strategy, drug, or medical treatment is safe and works to treat or prevent a health-related event. <strong><span style=\"color:#0066ff;\">Multi-centre trial<\/span><span style=\"color:#0066ff;\">s <\/span><\/strong>are clinical trials conducted at more than one hospital or clinic and are more likely to be valid than studies conducted at one place.<\/li>\n<li style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Health services and operational research:<\/strong>\u00a0<\/span> studies how health care is delivered and how people access health care.<\/li>\n<\/ul>\n<h2 style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Two\u00a0general\u00a0kinds of studies <\/strong><\/span><\/h2>\n<div style=\"text-align:center;\">\n<ul>\n<li style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Quantitative studies<\/strong><\/span> are the kind most often used in medical research, especially when looking at drugs and other treatments. These studies as questions such as <em>\u201chow many?\u201d<\/em> or <em>\u201chow much?\u201d<\/em> They count, measure, and compare things. For example, a quantitative study may count how many women taking a drug to prevent heart disease actually developed heart disease. Or, they may measure how much of a drug is needed to prevent heart disease. Another study might compare two drugs that prevent heart disease to see which one works better and has fewer side effects.<\/li>\n<\/ul>\n<\/div>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>Qualitative studies <\/strong><\/span>ask questions\u00a0like <em>\u201cwhy?\u201d<\/em> and <em>\u201chow?\u201d<\/em> This kind of research often uses interviews, surveys or other ways to observe people to find out how people think, feel, or act. For example, a qualitative study may ask: <em>\u201cWhy do girls start smoking?\u201d<\/em> Qualitative studies ask questions that are tough to answer with numbers.<\/li>\n<\/ul>\n<h2 style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Levels of evidence in studies<\/strong><\/span><\/h2>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>Systematic Reviews<\/strong> and <strong>Meta-Analysis<\/strong>:<\/span>\u00a0 Comprehensive and structured review of all studies on a specific topic, sometimes combines the data or statistics from the studies (meta-analysis)<\/li>\n<li><span style=\"color:#0066ff;\"><strong>Randomized Controlled Studies<\/strong>:\u00a0<\/span> Randomly assign study participants into two groups: those who get the treatment (case) and those who do not (control) to look for differences between the two groups. The chance of being in either group is 50\/50. It does not depend on things like how much a person needs treatment. A stronger form of this type of study is the <span style=\"color:#0066ff;\"><strong>Randomized Controlled Double-Blind Study<\/strong><\/span>. This form has the extra step of making sure that neither the researchers nor the study participants know who is getting the treatment or the placebo until the end of the study.<\/li>\n<li><span style=\"color:#0066ff;\"><strong>Cohort or Panel Studies<\/strong>:\u00a0<\/span> Observe a clearly defined group of people either forward in time (prospective) or looking back in time (retrospective) at previous medical records and other information; in<span style=\"color:#0066ff;\"> <strong>Observational Studies<\/strong><\/span>, individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given). Observational studies can&#8217;t prove cause and effect. They can show a strong statistical association, but cannot prove benefit or risk reduction.<\/li>\n<li><span style=\"color:#0066ff;\"><strong>Case-Control Studies<\/strong>:<\/span> \u00a0Compare two groups of people: people with a disease or condition (cases) to other people who have the same characteristics (such as age and sex) who do not have that condition (controls)<\/li>\n<li><span style=\"color:#0066ff;\"><strong>Case Series<\/strong>:\u00a0<\/span> Describe a number of cases<\/li>\n<li><span style=\"color:#0066ff;\"><strong>Case Reports<\/strong>:<\/span>\u00a0 Report on a single case<\/li>\n<li>Animal Research<\/li>\n<li>In Vitro (Test Tube) research<\/li>\n<li>Ideas, editorials, and opinions<\/li>\n<li>What my neighbours tell me they learned while watching the Dr. Oz show<\/li>\n<\/ul>\n<h2 style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Funding for research<\/strong> <\/span><\/h2>\n<ul>\n<li>usually comes from government departments, foundations, universities or corporations<\/li>\n<li><span style=\"color:#0066ff;\"><strong>ask where the money comes from<\/strong><\/span> because some funders may have a financial interest in what the study says. For example, a drug company paying for research on their drug wants the research to show that the drug they&#8217;ve spent hundreds of millions of dollars developing is effective and will be a big seller. Researchers are now more frequently disclosing their\u00a0 <span style=\"color:#0066ff;\"><strong><a href=\"http:\/\/ethicalnag.org\/2011\/01\/27\/integrity-in-science-report\/\" target=\"_blank\"><span style=\"color:#0066ff;\">&#8216;conflict of interest&#8217;<\/span><\/a><\/strong><\/span> issues for the study right on the research paper or journal article. Read the fine print.<\/li>\n<li>Check the <span style=\"color:#3366ff;\"><strong>author affiliations<\/strong><\/span> listed to see if any of the authors are full-time employees of the drug\/device company.<\/li>\n<\/ul>\n<h2 style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>The people studied<\/strong><\/span><\/h2>\n<ul style=\"text-align:left;\">\n<li style=\"text-align:left;\">Did the researchers study men only, women only, or both women and men (and was the sample group equally divided between genders or significantly more one-sided)?<\/li>\n<li>Were the study participants from a wide range of ethnicities, backgrounds, ages?<\/li>\n<li>If the researchers studied only certain types of women, their findings may not apply to all women. Ditto for men.<\/li>\n<li>Until recently, medical research has tended to study men and not recognize that there are differences between men\u2019s and women\u2019s health.<\/li>\n<li>Researchers are trying more to understand those differences using <span style=\"color:#0066ff;\"><strong>gender-based analysis <\/strong><\/span>or \u201cGBA\u201d.<\/li>\n<li>Was the group studied large enough? When a quantitative study looks at whether one treatment is better than another, or has dangers or side effects, researching a large population over a long period of time gives results that are more meaningful.<\/li>\n<li>Small groups are often used in qualitative studies. These studies look at an issue in-depth and can take a lot of time, so it is not always possible to have a large study group.<\/li>\n<\/ul>\n<h2 style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Statistics<\/strong><\/span><\/h2>\n<ul style=\"text-align:left;\">\n<li>Statistics are supposed to show whether something just happens by chance or because of the treatment that is being studied.<\/li>\n<li>Saying that <span style=\"color:#0066ff;\"><strong>statistics are<\/strong> <strong>significant <\/strong><\/span>means that the research results show that there is a<span style=\"color:#0066ff;\"> <strong>meaningful difference<\/strong><\/span> between the groups in the study and that the differences are so big that they are probably not due to chance. The difference between to two groups is then due either to the treatment that is being studied, or an error or bias in the study.<\/li>\n<li style=\"text-align:left;\">Statistics can also be used to show whether two things occur together, how large a difference is, the combined effects of many factors, or how something changes over time.<\/li>\n<li style=\"text-align:left;\">See also <span style=\"color:#0066ff;\"><strong>number needed to treat (NNT)<\/strong><\/span> under <em>Definitions<\/em>, below.<\/li>\n<li style=\"text-align:left;\">See also <span style=\"color:#0066ff;\"><strong>absolute risk <\/strong><span style=\"color:#333333;\">vs<span style=\"color:#0066ff;\"><strong> relative risk<\/strong><\/span><\/span><\/span>, under <em>Definitions<\/em>, below.<\/li>\n<\/ul>\n<h2 style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Bias<\/strong><\/span><\/h2>\n<p style=\"text-align:left;\">A bias is anything that influence the results of a research study. Different sources of bias can affect the study design, the data analysis, or the interpretation of the study results.<\/p>\n<ul style=\"text-align:left;\">\n<li>Medical research may focus on one disease or condition and only look at how some aspects of\u00a0patients&#8217; lives affect the condition.<\/li>\n<li>Some people feel better when they think they are receiving treatment, even if they are only getting a placebo, the so-called <strong><a href=\"http:\/\/ethicalnag.org\/2011\/03\/16\/placebo\/\" target=\"_blank\"><span style=\"color:#0066ff;\">placebo effect<\/span><\/a>.<\/strong><\/li>\n<li>People\u2019s memories are selective and volunteers can under- or overestimate answers to research questions. People sometimes give answers that they think are the<em> \u2018right\u2019<\/em> ones or what the researchers want to hear. Last year, a group of 45 international nutrition scientis<span style=\"color:#000000;\">ts <a style=\"color:#000000;\" href=\"http:\/\/myheartsisters.org\/2015\/10\/04\/girlfriends-tell-the-truth-nutrition\/\" target=\"_blank\">launched a campaign<\/a> to e<\/span>nd the use of one of their most commonly-used research tools: <span style=\"color:#3366ff;\"><strong>the self-reported food diary<\/strong><\/span><em>.<\/em>\u00a0 These scientists now claim that <em>\u201cdietary recall is skewed towards healthier behaviour.\u201d<\/em><\/li>\n<li>Sometimes, observations and conclusions may be influenced by stereotypes about groups of people.<\/li>\n<li style=\"text-align:left;\">There might be problems in the way that people were chosen or volunteer for the study so that the study participants are not representative of the larger society.<\/li>\n<li style=\"text-align:left;\">The more quantities researchers try to measure (<span style=\"color:#3366ff;\"><strong>multiple endpoints<\/strong><\/span>), the more likely it is that one will be statistically significant merely by chance, <span style=\"color:#3366ff;\"><strong>even if the experimental treatment does not work<\/strong><\/span>. This is why drug companies are required to report their primary study goals in advance &#8211; yet many still do not.\u00a0Since 2008 in the U.S. for example, the FDA has required results of all clinical trials to be posted within a year of completion of the study. However, an audit published in 2012 has shown that 80% of trials failed to comply with this law. See <em>selective outcome reporting<\/em> (under <em>Definitions<\/em>, below) or more on this from the <span style=\"color:#000000;\"><a style=\"color:#000000;\" href=\"http:\/\/www.alltrials.net\/find-out-more\/why-this-matters\/the-alltrials-campaign\/\" target=\"_blank\"><strong><span style=\"color:#3366ff;\">AllTrials<\/span><\/strong> campaign<\/a>.<\/span><\/li>\n<\/ul>\n<h2 style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Questions to ponder:<\/strong><\/span><\/h2>\n<ul style=\"text-align:left;\">\n<li>Did the study do what it set out to do?<\/li>\n<li>Do the conclusions follow from the information presented?<\/li>\n<li>Does the study <span style=\"color:#0066ff;\"><strong>overestimate benefits or underestimate dangers<\/strong>?<\/span><\/li>\n<li>If the study suggests drugs or therapies for prevention, was there longterm follow-up on the effects?<\/li>\n<li style=\"text-align:left;\">Do the results fit with older, more established evidence? Sometimes new research findings challenge established evidence.<\/li>\n<\/ul>\n<h2 style=\"text-align:left;\"><span style=\"color:#0066ff;\"><strong>Be suspicious of research presented at scientific meetings<\/strong><\/span><\/h2>\n<ul>\n<li>information presented in talks at scientific meetings may be<span style=\"color:#0066ff;\"> <strong>incomplete<\/strong><\/span><\/li>\n<li>research abstracts presented at prominent scientific meetings often receive substantial <span style=\"color:#0066ff;\"><strong>media attention before the validity of the work has been established<\/strong> <\/span>in the scientific community<\/li>\n<li>many of the abstracts receiving media attention have <strong><span style=\"color:#0066ff;\">weak designs<\/span><\/strong>, are small, or are based on animal or laboratory studies<\/li>\n<li>this work is generally <span style=\"color:#0066ff;\"><strong>not ready for public consumption<\/strong><\/span>: results change, fatal problems emerge, and hypotheses fail to pan out<\/li>\n<li>25% remained <strong><span style=\"color:#0066ff;\">unpublished<\/span><\/strong> more than three years after the meeting<\/li>\n<li>presentations that receive <span style=\"color:#0066ff;\"><strong>front-page coverage<\/strong><\/span> are no more likely to be published than abstracts receiving less prominent coverage<\/li>\n<li>results are frequently presented as scientifically sound evidence rather than as <span style=\"color:#0066ff;\"><strong>preliminary findings<\/strong><\/span> with still uncertain validity<\/li>\n<li>most findings have not undergone<span style=\"color:#0066ff;\"> <strong>final peer review<\/strong><\/span>, have yet to be independently vetted, and may change<\/li>\n<li>unlike at scientific meetings, evidence strength\u00a0of research published in <span style=\"color:#0066ff;\"><strong>peer-reviewed journals<\/strong><\/span> can be evaluated<\/li>\n<li style=\"text-align:left;\">physicians, confronted with preliminary research findings,\u00a0must be able to answer some fundamental questions such as:<em><span style=\"color:#0066ff;\"> &#8220;<strong>What is the rush<\/strong>?&#8221;<\/span><\/em><\/li>\n<li>develop a <strong><span style=\"color:#0066ff;\">healthy skepticism<\/span><\/strong> about the &#8216;breakthroughs&#8217; you repeatedly encounter in the news<\/li>\n<\/ul>\n<h6 style=\"text-align:right;\"><span style=\"color:#808080;\">Sources include: <\/span><em><a href=\"http:\/\/www.cwhn.ca\" target=\"_blank\"><span style=\"color:#808080;\">Canadian Women&#8217;s Health Network<\/span><\/a><\/em><span style=\"color:#808080;\"> and <\/span><em><a title=\"Tips For Understanding Studies\" href=\"http:\/\/www.healthnewsreview.org\/tips-for-understanding-studies.php\" target=\"_blank\"><span style=\"color:#808080;\">Health News Review <\/span><\/a><\/em><\/h6>\n<p style=\"text-align:center;\"><span style=\"color:#ffffff;\">.<\/span><\/p>\n<h1 style=\"text-align:center;\"><span style=\"color:#0066ff;\"><strong>DEFINITIONS<\/strong><\/span><\/h1>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>adverse event<\/strong>:<\/span> any undesirable experience associated with the use of a medical product in a patient. This includes both obvious drug side effects and other new health problems that occur during a drug trial that may not be drug related. An adverse event is considered severe if it leads to hospitalization, disability or death.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>astroturfing: <\/strong><\/span>political, advertising, or public relations campaigns that are formally planned by an organization or company, but designed to mask\u00a0their true\u00a0origins to create the impression of being spontaneous, popular <span style=\"color:#0066ff;\"><strong>\u201cgrassroots\u201d <\/strong><\/span>behaviour. (The term refers to <em>AstroTurf\u2122,<\/em> a brand of synthetic carpeting designed to look like natural grass).\u00a0<span style=\"color:#000000;\">\u00a0<a style=\"color:#000000;\" href=\"http:\/\/ethicalnag.org\/2010\/03\/22\/shill-game\/\" target=\"_blank\">Astroturfing campaigns<\/a> are\u00a0widely considered by us PR types to be behind the growing\u00a0trend towards noisy health care<\/span> protests and town hall meetings in the U.S.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>conflict of interest:<\/strong><\/span> this happens if a research study author or team member\u00a0is now receiving\u00a0or has previously\u00a0received money or any other benefits from the manufacturer of the drug or device being studied, or has\u00a0anything to gain if the study is positive towards the manufacturer.\u00a0 It&#8217;s generally suspected that you don&#8217;t bite the han<span style=\"color:#000000;\">d that feeds you. Some <a style=\"color:#000000;\" title=\"How are hockey-playing goons the same as \u201cpuzzled\u201d medical journal\u00a0editors?\" href=\"http:\/\/ethicalnag.org\/2009\/10\/14\/journal-editor-puzzled\/\" target=\"_blank\">medical journals<\/a> (not all) ask the authors of scientific papers being published in their journals to disclos<\/span>e any conflicts of interest, usually listed at the end of the article.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>data mining: <\/strong><\/span> happens when a research study doesn\u2019t show what researchers or funders wanted, and so they look at subgroups to tweak the data every which way until they get something that looks more positive.\u00a0 See also: <em>publication bias<\/em>,\u00a0 <em>file drawer effect<\/em> and <em>selective outcome reporting<\/em><\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>drug reps:<\/strong> <\/span>sales employees of pharmaceutical companies who visit physicians in order to convince them to prescribe their company&#8217;s drugs, or to up the dosage of these drugs<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>file drawer effect<\/strong>:<\/span>\u00a0 when negative research studies are not submitted for publication. See also <em>publication bias<\/em>,\u00a0<em> data mining<\/em> and <em>selective outcome reporting<\/em><\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>guest authors<\/strong>:<\/span> the names o<span style=\"color:#000000;\">f <a style=\"color:#000000;\" title=\"Medical ghostwriting and \u2018Guest Authorship\u2019: twins separated at\u00a0birth?\" href=\"http:\/\/ethicalnag.org\/2009\/09\/22\/guest-athors\/\" target=\"_blank\">well-known physicians, academics or scientists<\/a> added to the published list\u00a0of\u00a0authors\u00a0in a journal article\u00a0even though th<\/span>ey did not write the article; often included as a &#8216;tribute&#8217; to a department chair or the person who successfully arranged funding for the research because the &#8216;guest author&#8217; gets to\u00a0take credit for\u00a0the title on a career list of publications even if he\/she\u00a0didn&#8217;t do the work.\u00a0 See also: <em>medical ghostwriting<\/em><\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>marketing:<\/strong><\/span>\u00a0 the process of interesting potential customers and clients in products and\/or services; involves researching, promoting, selling, and distributing products or services.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>medical ghostwriting: <\/strong><\/span> when someone makes substantial \u00a0contributions to a manuscript without being credited. <strong><span style=\"color:#0066ff;\"><em>&#8220;It is considered bad publication practice in the \u00a0medical sciences, and some argue it is <\/em><\/span><span style=\"color:#0066ff;\"><em>scientific misconduct<\/em><em>&#8220;<\/em><\/span> <\/strong>according to Danish researcher <strong><span style=\"color:#0066ff;\"><a href=\"http:\/\/ethicalnag.org\/2009\/09\/04\/ghostwriting1\/\" target=\"_blank\"><span style=\"color:#0066ff;\">Dr. Peter G\u00f8tzsche<\/span><\/a><\/span><\/strong>.\u00a0<strong><em><span style=\"color:#0066ff;\">&#8220;<\/span><\/em><\/strong><span style=\"color:#000000;\"><em>At its extreme, medical ghostwriting involves pharmaceutical companies hiring professional writers to produce papers promoting their products <\/em><em>&#8211; but hiding those contributions and instead naming academic physicians or scientists as the authors.&#8221;<\/em> \u00a0See also <\/span><em><span style=\"color:#000000;\">&#8216;gues<\/span>t authors&#8217;.<\/em><\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>number needed to treat, <\/strong><span style=\"color:#333333;\">or<span style=\"color:#0066ff;\"><strong> NNT:<\/strong><\/span><\/span><\/span>\u00a0 offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on just one person. The concept is statistical but intuitive, because we know that not everyone is helped by a medicine or intervention; some benefit, some are harmed, and some are unaffected. The NNT tells us how many of each.<strong> <span style=\"color:#0066ff;\"><a href=\"http:\/\/www.thennt.com\/\" target=\"_blank\"><span style=\"color:#0066ff;\">This website<\/span><\/a><\/span> <\/strong>from a bunch of very brainy physicians working in emergency medicine has the most helpful explanation of NNT that I&#8217;ve seen yet, along with a list of credible resource links to check NNT stats on several therapies currently recommended for a number of different conditions.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>optics:\u00a0<\/strong><\/span> in the public relations field, this has <span style=\"color:#000000;\"><em>&#8220;nothing to do with the eyes, but it has everything to do with the way the public sees things&#8221;<\/em> as <\/span><em><span style=\"color:#000000;\">Th<\/span>e Globe and Mail<\/em> called this description of perception back in 1983.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>peer review<\/strong><\/span>: when a medical research paper is submitted to a scientific journal, editors send it to experts in the field who anonymously look for problems in the conduct and analysis of the study and overstatements or leaps of logic in the paper. These peer reviews recommend whether the paper should be accepted, rejected outright or sent back for major revisions.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>placebo:<\/strong><\/span> looks like medicine, but isn&#8217;t; used to be called <span style=\"color:#000000;\">a &#8216;<a style=\"color:#000000;\" title=\"Amazing (and strange) examples of placebo miracle\u00a0effects\" href=\"http:\/\/ethicalnag.org\/2011\/03\/16\/placebo\/\" target=\"_blank\">sugar pill<\/a>&#8216;<\/span><\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>primary endpoint<\/strong><\/span>: the primary goal of a trial; examples include prolonging survival or curing infections. It&#8217;s decided before a research trial begins. If a trial doesn&#8217;t succeed in meeting its primary endpoint, it is considered a failure, even if there is evidence of other beneficial effects.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>public relations (or PR)<\/strong><\/span>: the actions of a corporation, business,\u00a0 government, individual in promoting goodwill between itself and the public, the community, employees, customers, etc;\u00a0 the art, technique, or profession of promoting such goodwill.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>publication bias: <\/strong><\/span>when academic or medical journals are less likely to publish negative studies. See also<em> file drawer effect<\/em>, <em>selective outcome reporting<\/em> and <em>data mining<\/em>.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>risk<\/strong>:\u00a0<\/span> includes two important types of risks revealed in science, <a title=\"Absolute risk, relative risk \u2013 and red\u00a0meat\" href=\"http:\/\/ethicalnag.org\/2012\/06\/02\/red-meat-and-heart-health\/\" target=\"_blank\"><span style=\"color:#0066ff;\"><strong>absolute risk<\/strong><\/span> <span style=\"color:#000000;\">vs<\/span>. <span style=\"color:#0066ff;\"><strong>relative risk<\/strong><\/span><\/a>. In <span style=\"color:#0066ff;\"><strong>absolute risk<\/strong><\/span>, for example, risk is stated without any context. You have a 50% chance of flipping a coin and getting heads, or a 1% (one in a hundred) chance of getting lung cancer even if you have never smoked. These risks are not compared to any other risk &#8211; they are just the probability of something occurring. In <span style=\"color:#0066ff;\"><strong>r<\/strong><strong>elative risk<\/strong><\/span>, however, a comparison is made between different risk levels. For example, your relative risk for lung cancer is (approximately) 10 if you have ever smoked, compared to a non-smoker. This means you are 10 times more likely to get lung cancer. If the risk is about 1% for a nonsmoker, this translates to about 10% for a person who has smoked (but even higher for heavy smokers). Remember that the relative risk (or risk ratio) is <span style=\"color:#0066ff;\"><strong><em>NOT<\/em> the same as an increase in risk<\/strong><\/span>.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>selective outcome reporting<\/strong><\/span>: when study authors cherry-pick research results by publishing the good ones favourable to the product being studied, while ignoring the bad ones. See also:<em> publication bias, <\/em><em>file drawer effect<\/em>, <em>data mining, <\/em>as well as the <span style=\"color:#3366ff;\"><a style=\"color:#3366ff;\" href=\"http:\/\/www.alltrials.net\/find-out-more\/why-this-matters\/the-alltrials-campaign\/\" target=\"_blank\"><strong>AllTrials campaign<\/strong><\/a> <\/span>to force drug\/device companies to report all results.<em><br \/>\n<\/em><\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>shills: <\/strong><\/span> this word originally, maybe as far\u00a0back as 1914,\u00a0denoted a carnival worker who pretended to be a member of the audience in an attempt to elicit interest in an attraction.\u00a0\u00a0Both illegal and legal gambling industries use shills to make winning at games appear more likely than it actually is. In online fo<span style=\"color:#000000;\">rums, <a style=\"color:#000000;\" href=\"http:\/\/ethicalnag.org\/2010\/03\/22\/shill-game\/\" target=\"_blank\">shills<\/a> m<\/span>ay express specific opinions in order to further the interests of an organization in which they have an interest, such as an employee, commercial vendor or special interest group. Sometimes shills may be used to downplay legitimate complaints posted by users on the internet forum.<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>sock puppetry: <\/strong><\/span>an online scam usually seen in community forums or letters to the editors in which people sign on as one user soliciting recommendations for a specific product or service, and then sign on as a different user pretending to be a satisfied customer of a specific company. In many jurisdictions and circumstances, this type of activity may be and should be\u00a0illegal. See also:<span style=\"color:#000000;\"> <em><a style=\"color:#000000;\" href=\"http:\/\/ethicalnag.org\/2010\/03\/22\/shill-game\/\" target=\"_blank\">Sock Puppetry, Astroturfing and the Marketing Shill Game<\/a><\/em><\/span><\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>surrogate endpoint <\/strong><\/span>(also sometimes called <span style=\"color:#0066ff;\"><strong>secondary<\/strong><\/span> or <span style=\"color:#0066ff;\"><strong>intermediate<\/strong><\/span> endpoint): measurements that are not the main goal of the clinical trial. They are usually used as supporting data about a medicine&#8217;s efficacy or to spell out potential side effects. See also:\u00a0<span style=\"color:#000000;\"><em><a style=\"color:#000000;\" title=\"Your health, ball possession, and the World\u00a0Cup\" href=\"http:\/\/ethicalnag.org\/2010\/06\/25\/health-world-cup\/\" target=\"_blank\">Your Health, Ball Possession, and the World Cup<\/a><\/em><\/span><\/li>\n<\/ul>\n<ul>\n<li><span style=\"color:#0066ff;\"><strong>thought leader<\/strong><\/span> &#8211; a flattering word that industry &#8211; particularly drug and medical device companies &#8211; likes to use when recruiting physicians or academics to take money in exchange for educating their peers in order to help boost sales of their products. See also:<span style=\"color:#000000;\"> <em><a style=\"color:#000000;\" title=\"Is your doctor a \u201cthought\u00a0leader\u201d?\" href=\"http:\/\/ethicalnag.org\/2010\/10\/31\/is-your-doctor-a-thought-leader\/\" target=\"_blank\">Is your doctor a \u201cthought leader\u201d?<\/a><\/em><\/span><\/li>\n<\/ul>\n<p style=\"text-align:center;\"><span style=\"color:#0066ff;\"><strong>See also:<\/strong><\/span><\/p>\n<ul>\n<li style=\"text-align:center;\"><span style=\"color:#000000;\"><em><a style=\"color:#000000;\" href=\"http:\/\/ethicalnag.org\/2009\/10\/26\/tooth-fairy-science\/\" target=\"_blank\">Dr. Harriet Hall Explains Tooth Fairy Science <\/a><\/em><\/span><\/li>\n<\/ul>\n<p><span style=\"color:#000000;\"><br \/>\n<\/span><\/p>\n<p><a href=\"http:\/\/twitter.com\/#%21\/TheEthicalNag\"><img data-attachment-id=\"5726\" data-permalink=\"https:\/\/ethicalnag.org\/?attachment_id=5726\" data-orig-file=\"https:\/\/carolynthomas.files.wordpress.com\/2011\/04\/twitter-blue1.png\" data-orig-size=\"200,100\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;}\" data-image-title=\"twitter-blue1\" data-image-description=\"\" data-medium-file=\"https:\/\/carolynthomas.files.wordpress.com\/2011\/04\/twitter-blue1.png?w=200\" data-large-file=\"https:\/\/carolynthomas.files.wordpress.com\/2011\/04\/twitter-blue1.png?w=200\" class=\"aligncenter size-thumbnail wp-image-5726\" title=\"\" src=\"https:\/\/carolynthomas.files.wordpress.com\/2011\/04\/twitter-blue1.png?w=175&#038;h=87\" alt=\"\" width=\"175\" height=\"87\" srcset=\"https:\/\/carolynthomas.files.wordpress.com\/2011\/04\/twitter-blue1.png?w=175&amp;h=87 175w, https:\/\/carolynthomas.files.wordpress.com\/2011\/04\/twitter-blue1.png 200w\" sizes=\"(max-width: 175px) 100vw, 175px\" \/><\/a><\/p>\n","thumbnail_url":"http:\/\/carolynthomas.files.wordpress.com\/2009\/09\/blue-ball-arrow-play.jpg?fit=440%2C330","thumbnail_width":null,"thumbnail_height":null}