Podcast 017: Medical Research With Julia Chapman

Fake medicine is based on hogwash and wizardry, while real medicine is based on evidence and clinical trials.

Without the guidance of data, patient management is in confusion! No one really knows what to do! That makes medical research integral to accurate diagnosis and treatment.

In this episode, Julia talks about life as a medical researcher, how research applies to medical doctors and the challenges that research involves.

Podcast

About the guest speaker

Julia Chapman has worked at the Woolcock Institute since 2008 across a range of industry sponsored and investigator driven sleep and respiratory clinical trials. She recently completed her PhD which focussed on the treatment of daytime sleepiness in OSA with wakefulness promoters modafinil and armodafinil, including the longest randomised controlled trial of either of these drugs in OSA.

Julia left school thinking that she would one day be a professor of languages, but after studying pharmacology at the University of Sydney, she found that science was her passion. For her initial PhD work on the use of modafinil in mild-moderate OSA patients not using other treatments, she was awarded the Australasian Sleep Association’s New Investigator Award in 2013. She was awarded a postdoctoral research fellowship from NeuroSleep under the supervision of A/Prof Nat Marshall and Prof Ron Grunstein, who together are part of a team planning to establish a Sleep Clinical Research Network in Sydney and surrounding areas. She is now working on establishing research into the combined effects of shift work and OSA, as well as research in insomnia and chronic fatigue syndrome.

Music credits

Opening and closing themes by Lily Chen.

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Spurious Causations

What has the biggest association with death?

Cardiovascular disease?

Malignancy?

Suicide?

Motor vehicle accidents?

No.

The answer is birth. 100% of people who are born also die.

But while birth is a necessary precursor to death, is it fair to say that birth causes death? Hardly, unless you’re in an existential crisis.

Beware the post hoc ergo propter hoc fallacy; just because Event B follows Event A does not mean that A causes B.

References

  1. Dawes, R. M., & Kagan, J. (1988). Rational choice in an uncertain world. San Diego: Harcourt Brace Jovanovich.

Listen To The Authority

You’re waiting at a bus stop in unfamiliar territory; on this exciting day, you’re going to a park you’ve never been to before. New park, new children to cruelly push off the swings. It sounds glorious.

According to the timetable, the bus you want to catch will arrive at 2:06pm. You prepare yourself for a small wait.

While sitting and picking your nose, you see another bus pull up. You ask the driver if the bus is heading to where you want to go, thinking it might be a shortcut.

“NO!” cries the bus driver emphatically. “In fact, the service you’re after doesn’t run on weekends! You have to go to the other bus stop down the street and wait there.”

This is not what the timetable says. But the bus driver is yelling at you and seems so sure. You ruminate as he trundles off.

Who do you listen to? That depends on who the credible authority is.

If bus stop information is regularly updated and results are correlated by searching a travel app or website, that could well be the credible authority. Recall that a bus driver can only vouch for his or her own route and, vitally, has no personal or reputational stake in whether you actually catch your bus or not. He or she might give you information believed to be true, but that doesn’t mean it’s correct.

However, suppose the timetable is not well-maintained. In fact, you notice the paper peeling as though it hasn’t been updated in many years. Furthermore, let’s say that drivers have knowledge across multiple routes. In that case, you know who the credible authority is.

Importantly, if you jump on bad information, it can take you far from your intended destination. You end up worse off than when you started. Even if the credible source says to wait a little, you’re better off doing that, because it will pay off in the long run.

Searching for trustworthy medical information is no different. Except there are no buses involved. And it’s totally different.

When you’re starting out, it can be tough to differentiate between credible and less credible sources. Unreliable sources are often littered with telling advertisements like “LOSE 4LBS IN 5 DAYS!!!!!!”, but this isn’t always the case.

Bad information is worse than no information. This is why looking in the right place matters.

How do you identify the right place? Look out for:

https://www.hon.ch/images/imgHonCode.jpg

These are organisations that come from a trustworthy background, have a reputational interest to uphold or have been vetted for by someone who cares. With multiple other sources available, such as UpToDate, there’s little excuse for subscribing to bad information in this technological age.

It shouldn’t need to be said, but worryingly it still does: sites like howtogetbiggerboobsnaturallyfast.com are unlikely to be unbiased or trustworthy.

And it might be a personal bias, but staying wary of sites with keywords like “natural health advisor” or “homeopathic gluten free nutrition expert” has proved wise so far.