Becoming a better armchair epidemiologist
Bearing in mind a few basic principles will help in appraising COVID-19 research news, Samantha Shapiro says.
Prior to the COVID-19 pandemic, when I told people that I study epidemiology, they usually asked me if that had something to do with skin disease. Nowadays, it is hard to imagine someone not knowing what epidemiology is, or not having some type of epidemiological opinion of their own.
Close to 2,000 scientific papers have been published regarding COVID -19 in 2020, with equally frantic reporting coming from the media. Topics range from drug efficacy to danger of the disease, and results conflict from one day to the next. Staying up-todate and forming educated opinions is undoubtedly tough — yet even without an epidemiology degree, there are a few points that non-scientists can keep in mind to appraise new findings and become better armchair epidemiologists.
Be wary of articles available prepublication: Before being published in a scholarly journal, submitted papers are sent out to other experts for peer review. During this time, the methodology, interpretations, statistics and other aspects of the manuscript are scrutinized to ensure that the findings are scientifically sound. Papers are hardly ever published in their original version, and it is not uncommon for a manuscript to undergo two to three rounds of revisions. Since timely information is of the essence during a pandemic, it is common for articles to become available online pre-review, where they often capture media attention. Check for a statement on whether an article has undergone peer review.
Consider the study methodology: Different study designs provide different strengths of evidence. Animal studies, in vitro studies (studies not done in living beings), and case reports and series (studies stemming from one or a handful of individuals) are the lowest in the hierarchy, whereas randomized controlled trials and systematic reviews and meta-analyses (studies aggregating data from all available publications on the topic) provide the strongest evidence. Large sample sizes are also important — the larger the study population, the greater the odds that the findings hold true to the population at large. Remember that not all studies are equal.
Avoid generalizing results:
The results of a study conducted primarily in white elderly men may not hold true for middle-aged Hispanic women, and the same applies for middle-aged Hispanic women living in the United States versus Latin America. Disease susceptibility, access to health care, prevalence of comorbidities and other important variables in medical research are highly susceptible to biological, socioeconomic and cultural factors. These include race, age, socioeconomic status, urban/rural status, country of residence and countless others. Look for a well-balanced study population and keep in mind the defining characteristics of the study population.
Read beyond the headlines:
On May 3, headlines reported over 2,200 new COVID cases in Quebec, compared to an average of 912 new cases per day in the week prior. The articles stated that the surge in cases was partly due to reclassification of 1,317 cases from the month of April. However, this information was absent from most headlines, resulting in that day’s situation sounding much worse than the reality.
Seek predigested information: In the era of technology, expert opinions are available from a multitude of sources. Montreal Gazette columnists Joe Schwarcz and Christopher Labos and physician Mitch Shulman on CJAD are examples of Montreal-based scientists who examine the available literature, evaluate what’s sound and what’s not, and report it in ways that are easy for the lay public to understand. (Schwarcz is a Mcgill University chemistry professor and Labos is a physician; both are affiliated with the Mcgill Office for Science and Society.) Take advantage of the knowledge of experts in the field.
Although the data are changing every day, the fundamentals of epidemiology are holding steady. Let’s keep these principles in mind to make sense of it all. Samantha Shapiro is completing a Master of Science in Epidemiology at Mcgill University. She is also assistant editor for Preventive Medicine and Preventive Medicine Reports, two international public health journals.