What's a doctor to do when findings change course? Guiding patients through evolving medical evidence

Medicine is complicated, and new research has conspired to make it even more so, physicians say.

By Susan J. Landers, AMNews staff. March 13, 2006.

Washington -- In recent weeks, the realm of health evidence has experienced a seismic shift, and physicians are eyeing new findings with caution and recommending that patients do the same.

Fresh studies seem to contradict standard medical advice such as the ideas that low-fat diets are heart-healthy and calcium and vitamin D provide good protection against fractures. Thus, helping patients sort through the maze of conflicting research results -- always a challenge --is even more difficult.

Keeping up with such developments when medical news hits the morning papers and television is now an important part of a physician's job. Many of the news articles even urge people to "ask their doctors" about anything and everything.

But at the same time, physicians are becoming savvy to shifting data, and most can readily resolve confusion. All too often, findings diverge from what's seen as common wisdom.

Vitamin E is a good example, said Donna Sweet, MD, an internist in Wichita, Kan. "First it was in, and then it was out, and then in again, and now it's out."

Hormone replacement is another classic illustration. Estrogen and progestin had been thought to protect women's hearts until the Women's Health Initiative turned that notion on its head in 2002. Now a new look at the data suggests women ages 50 to 59 who take estrogen alone might lower their risk for coronary heart disease.

This latest interpretation could seem something of a flip-flop to women who turned away from HT when initial findings were released.