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Citizen scientists: The new research corps

November 28, 2012 By 1 Comment

More often than ever before, people from all walks of life –  from retired senior citizens to young families – are helping scientists collect data that support research projects. This movement of “citizen science” has flourished over the past decade as technology has advanced, allowing volunteers to share information with researchers quickly and accurately.

In fact, there are several interesting examples of “citizen science” here at Cornell University, including a survey of backyard birds and a project called Yardmap that encourages homeowners to map their yards so that researchers can better understand the habitat available to birds.

This month, a group of researchers from the United Kingdom has published a review that details exactly how “citizen science” is working, including summaries of projects across the globe, interviews with scientists who use this data and , and a guide of the best practices for conducting these types of projects. The review found some interesting conclusions. Among them:

  • The motivation for citizen scientists varies greatly. Successful projects tend to take into account the interests and skill-sets of participants, and their expectations.
  • Getting feedback from volunteers is an important component of a sucessful project and is acheived through a wide variety of mediums, including social media and face-to-face interactions.
  • Technologies such as GPS and smart phones have made it easier for citizens to share accurate data, but relying on these devices excludes those who don’t have access to them.

Cornell gerontologist Karl Pillemer is a proponent of “citizen science” for people in their 60s, 70s and 80s. He has conducted research that found that older adults who get involved in creating a sustainable society and conserving natural resources are not only helping the environment, they are also helping themselves.

“Research shows that citizen science activities provide a wonderful opportunity to achieve two goals at once: Adding to our knowledge about areas important to quality of life for people, while also providing opportunities for rewarding and meaningful activity,” he said. “And citizen science activities can be adapted for any life course stage, from elementary school students to retirees.”

In short, projects that use citizen volunteers to collect data are an important part of environmental research today, and understanding the best practices for this type of research is important.

Filed Under: Evidence-Based Living, The Learning Center Tagged With: , ,

The facts on Social Security

October 1, 2012 By Leave a Comment

More than 75 years ago, the U.S. government created Social Security, the federal insurance program that provides benefits to individuals and their families who can no longer work because of disability, retirement or death. The program is complex, and its details are often debated among politicians.

Earlier this year, the Economic Policy Institute and the National Academy of Social Insurance published a guide that explains the facts about the Social Security program to young people. The document includes detailed, evidence-based explanations of Social Security’s history, beneficiaries, financing, and shortfalls. It pulls data from the Office of the Chief Actuary of the Social Security Administration, Congressional Budget Office, the Employee Benefits Research Institute, and the Center for Retirement Research.

Here’s a sampling of interesting facts from the document:

  • In 2012, about 159 million individuals or 94% of the American workforce, worked in Social Security-covered employment. (Those not covered include government employees covered by other insurance programs, farm workers who do not meet minimum work requirements and students.)
  • Approximately 55 million Americans received Social Security benefits in 2011. Seventy percent were retirees; 19 percent were disability beneficiaries and 11 percent were survivors of deceased workers.
  • Without Social Security income, it is estimated that nearly half senior citizens would be living in poverty. Instead, fewer than 10 percent of seniors live in poverty.
  • Because the U.S. population is aging and people are living longer, the Social Security program is projected to run up a deficit. The projected shortfall is 2.67% of taxable earnings over the next 75 years.
  • There are a variety of ways to compensate for the deficit including raising taxes, expanding coverage, investing in equities, increasing the retirement age and reducing cost-of-living increases.

The guide concludes that Social Security fulfills an important need in our society as an insurance program for American workers.  To learn more about Social Security benefits and about how your payroll taxes are used, it’s worth checking out this evidence-based document.

Filed Under: Evidence-Based Living, policy, The Learning Center Tagged With: , , ,

A roadmap: How to use research to help people

May 24, 2012 By Leave a Comment

The idea of translational research initially sprung out of the field of medicine, where doctors and scientists have teamed up to move laboratory discoveries more rapidly into clinical settings to help patients improve their health and recover from ailments.

Since its beginnings several decades ago, researchers working in other disciplines have latched onto the idea of translation. Now a new book offers models for social and behavioral scientists who want to transfer their findings into real world settings.

The book – “Research for the Public Good: Applying the Methods of Translational Research to Improve Human Health and Well-Being” – includes chapters by experts in the fields of psychology, child development, public policy, sociology, gerontology, geriatrics and economics that offer road maps for translating research into policies and programs that improve the well-being of individuals and communities. It  is co-edited by Cornell professors Elaine Wethington and Rachel Dunifon.

The book grew out of second Biennial Urie Bronfenbrenner Conference on translational research held at Cornell and attended by leading experts in the social sciences and medical fields.

“Translational research has gained prominence in biomedical research, where there’s an emphasis on speeding lab findings into practice,” Wethington told the Cornell Chronicle. “It also goes back to the work of Urie Bronfenbrenner and his colleagues, however, who were ahead of their time with an ecological approach to human development that brought together research, policy and practice. This book defines the term in that context and provides practical insights for doing translational research.”

Graduate students and early-career scientists unfamiliar with translational research methods should find the book valuable, Wethington said. “There is a surge of interest in the field right now, so the book should be a great resource,” she said.

Filed Under: Evidence-Based Living, The Learning Center Tagged With: ,

A clearinghouse of education evidence

March 8, 2012 By 1 Comment

Parents across the nation send their children to public schools with the confidence that principals and teachers are providing an environment where children can learn, grow and thrive.

We hear so much about in the news about ways to improve our education system – especially in this presidential election year, when candidates are offering proposals and counter-proposals to fix our schools.

But is there any evidence as to what really works?  As a parent of young children, our schools are one important place where I want to see evidence-based guidelines put in place.

The best place I’ve found for evidence-based information on education is called the What Works Clearinghouse, an initiative by the U.S. Department of Education that conducts systematic reviews on education research to provide educators with the information they need to make evidence-based decisions.

The project is a true treasure trove of information, with research reviews on a myriad of topics including dropout prevention, school choice, early childhood education and student behavior, to name just a few.

On a recent cruise through the site, several topics piqued my interested including:

I’m certainly going to share this amazing resource with my son’s teachers, and use to gather information about the curriculums he’ll be learning in elementary school.  As a parent, it’s a relief to know there’s a place to look for reliable, evidence-based information on education.

Filed Under: Evidence-Based Living, policy, The Learning Center, Youth Development Tagged With: , , , , ,

Missing data: The Achilles heel of systematic reviews

January 6, 2012 By Leave a Comment

If you’re a regular reader of EBL, you know we’re huge fans of systematic reviews – studies in which researchers use sophisticated methods to bring together and evaluate the dozens, hundreds, or even thousands of articles on a topic.

We value these analyses because they collect all of the information available and then look at why and how each study differs. By looking at so many studies, researchers can make general conclusions, even though participants and study settings might be different.

So we took a great interest this week in a series of studies in the British Medical Journal making the case that many medical studies aren’t published, and therefore missing from systematic reviews and the decision-making processes of doctors and patients.

One of the studies found that fewer than half of the clinical trials funded by the National Institutes of Health from 2005 to 2008 were published in peer-reviewed journals within 30 months of study completion, and only 68 percent were published at all.

Another examined trials registered at the federal web site ClinicalTrials.gov during 2009. Of the 738 studies registered and subject to mandatory reporting guidelines (per the rules of the U.S. Food and Drug Administration), only 22 percent reported results within one year.  (It’s interesting to note that trials of medicines in the later stages of development and those funded by the drug industry were more likely to have results reported.)

A third study re-analyzed 41 systematic reviews of nine different medicines, this time including unpublished clinical trial data from the FDA in each analysis.  For 19 of the systematic reviews, the addition of unpublished data led to the conclusion that the drug was not as effective as originally shown. For 19 other reviews, the additional data led to the conclusion that the drug was more effective than originally shown.

Dr. Harlan Krumholz, a cardiologist at Yale and a internationally-respected expert in outcomes research, summarized the issue in his Forbes magazine blog, including some of the reasons that data goes unreported. (Among them, researchers may not be happy with the results or may shift focus to a new study. And medical journals may not be receptive to negative results.)

Whatever the reasons, the take-home message seems to be that researchers and publishers need to do a better job getting all of the information out in the public domain so that doctors and patients can truly make informed decisions.

Filed Under: Evidence-Based Living, In The Media, The Learning Center Tagged With: , , , ,

More evidence supporting the systematic review

December 14, 2011 By 2 Comments

Frequent EBL readers are well aware of the importance we put on systematic reviews, studies that synthesize many articles on a given topic and draw a conclusion about what the body of evidence shows.

So we were excited this week to stumble across a paper funded by the Milbank Memorial Fund and the U.S. Centers for Disease Control extolling the virtues of the systematic review for improving health across populations – especially for our policymakers.

The paper includes case studies on a wide range of topics — underage drinking, tobacco use and traffic safety interventions, to name a few.

And it draws the following conclusions about systematic reviews, in general:

  • Policymakers should feel confident about the findings of systematic reviews because, by definition, they help reduce the bias often present in single studies.
  • Systematic reviews help policymakers work efficiently and reduce the influence of outside interests.
  • Researchers in all fields must make strategic efforts to publicize and implement review findings. (Here at EBL, we’re doing our best in this area!)
  • Enhancing the “literacy” of decision makers and the public about the strengths and weaknesses of different types of evidence can help improve population health policy.

So there you have it: More evidence in support of the systematic review.  The next time you’re thinking about making a health decision, considering checking the body of evidence. Just Google “systematic review” along with the topic you’re interested in and see what you can find.

Filed Under: Evidence-Based Living, policy, The Learning Center Tagged With: , , ,

Video feature: Q&A on decision-making

December 2, 2011 By 1 Comment

Most of us have seen it before.  Maybe it was a neighborhood boy riding his bike down the middle of the road, or a group of girls performing stunts on the diving board at the local pool. Whatever the circumstance, it’s fairly common knowledge that young people don’t always make the best decisions. In fact, it’s a topic we’ve written about here on EBL.  But given the stakes, it’s one worth revisiting.

Earlier this month, Cornell professor Valerie Reyna — an expert in decision-making  — was featured in a new video on the topic.  In it, Reyna explains the science behind decision-making in adolescents, as well as how the neuroscience of decision-making plays a role in other areas of our lives including health care and memory.

It’s certainly worth a watch!

Filed Under: Evidence-Based Living, The Learning Center Tagged With: , , , ,

What does the evidence say about risk communication?

August 22, 2011 By 1 Comment

The U.S. Food and Drug Administration has published a new report that’s right up our alley. It’s called Communicating Risks and Benefits: An Evidence-Based User’s Guide.

The introduction offers an explanation of evidence-based health communications that we believe should be the standard for all organizations, from corporations to government agencies to universities.

“…Sound communications must be evidence-based in two related ways. One is that communications should be consistent with the science — and not do things known not to work nor ignore known problems. The second is communications should be evaluated — because even the best science cannot guarantee results. Rather, the best science produces the best-informed best guesses about how well communications will work. However, even these best guesses can miss the mark, meaning that they must be evaluated to determine how good they are and how they can be improved.”

The report goes onto address the concept of communicating risks and benefits across a wide range of fields – in health provider settings, news coverage and corporate communications to name a few – and offer practical tips about using evidence in all sorts of communications.

Cornell’s own Valerie Reyna, whom we’ve written about before, authored Chapter 12 about communicating risks and benefits to people of all ages, and her work is extensively quoted in other chapters of the report.

The report is chock-full of useful recommendations.  Among them are:

  • Health professionals should receive specific training on how to communicate the risks and benefits of medical procedures and medicines.
  • Provide information along with explaining meaning to help consumers make good decisions.
  • Test the readability of health care messages to ensure they use plain language.

If you work in the field of health care, this report is a must-read!

Filed Under: Evidence-Based Living, Health and Wellness, policy, The Learning Center

Randomized, controlled designs: The “gold standard” for knowing what works

April 23, 2011 By 4 Comments

You’re having trouble sleeping one night, so you finally give up and turn on the TV. It’s 2 AM, so instead of actual programs, much of what you get are informercials. As you flip through these slick “infotainment” shows, you hear enthusiastic claims about the effectiveness of diet pills, exercise equipment, and a multitude of other products

You will soon see that almost every commercial uses case studies and testimony of individuals for whom the product has supposedly worked. “I lost 50 pounds,” exults a woman who looks like a swimsuit model. “I got ripped abs in 30 days,” crows a man who, well, also looks like a swimsuit model.

The problem is that this kind of case study and individual testimony is essentially worthless in deciding if a product or program works. The main problem is that it’s very hard to disprove case study evidence. Look at the informercials – they seem to have worked for some people, but what about all the people who failed? And how do we know that the people who lost weight, for example, wouldn’t have done so without buying the product?

So case studies and testimonials aren’t worth much because they don’t give us the kind of comparative information needed to rule out alternative explanations.

To the rescue comes experiments using randomized, controlled designs (RCD). Such experiments are rightly called the “gold standard” for knowing whether a treatment will work. In a RCDs, we create a test so that one explanation necessarily disconfirms the other explanation. Think of it like a football game. Both teams can’t win, and one eventually beats the other. It’s the same with science: our knowledge can only progress if one explanation can knock out another explanation.

 The main weapon in our search for truth is control group designs.  Using control groups, we test a product or program (called the “treatment”) against a group that doesn’t get whatever the treatment is.

 Case studies simply don’t have the comparative information needed to prove that a particular treatment is better than another one, or better than just doing nothing. And that’s important because of the “placebo effect.” It turns out that people tend report that a treatment has helped them, whether or not there is any actual therapy delivered. In medicine, placebo effects very strong, and in some cases (like drugs for depression) the placebos have occasionally been found to work more effectively than the drugs.

 So what is a randomized, controlled design? There are four components of RCDs:

 1. There is a treatment to be studied like a program, a drug, or a medical procedure)

 2. There is a control condition. Sometimes, this is a group that doesn’t’ get any treatment at all. Often it is a group that gets some other kind of treatment, but of a different kind or smaller amount.

3.  Now here’s the key point:The participants must be randomly assigned to treatment or control groups. It is critical that nobody – not the researchers, not the people in the experiment – can participate in the decision about which group people fall into. Some kind of randomization procedure is used to put people into groups – flipping a coin, using a computer, or some other method. This is the only way we can make sure that the people who get the intervention will be similar to those who do not.

4. There must be carefully defined outcome measures, and they must be measured before and after the treatment occurs.

Lots of the bogus claims you see on TV and elsewhere look only at people who used the product. Without the control group, however, we can’t know if the participants would have gotten better with no treatment at all, or with some other treatment.

Catherine Greeno, in an excellent article on this topic, sums up why we need to do RCDs if we want to understand if something really does or doesn’t work. She puts it this way:

  • We study a treatment compared to a control group because people may get better on their own.
  • We randomly assign to avoid the problem of giving worse off people the new treatment because we think they need it more.
  • We measure before and after the treatment so that we have measured change with certainty, instead of relying on impressions or memories.

 So when you are wondering if a therapy, treatment, exercise program, product, etc. are likely to work, keep those three little words in mind: Randomized, Controlled Design!

Filed Under: Evidence-Based Living, The Learning Center Tagged With: , , , ,

Alternative medicine: How to figure out what works (and what doesn’t)

April 10, 2011 By 6 Comments

When I tell people about the Evidence-Based Living Blog, many of them want to know about alternative medical treatments. “Does X really work?” they will ask. “X” could be anything from ginkgo biloba, to meditation, to massage, to dietary supplements. Answering that question has always been hard for me, because finding and evaluating the evidence seems so complex.

The clearest explanation I have ever seen comes from Dr. Mark Lachs in his terrific new book Treat Me, not My Age. It’s a book targeted to the baby boomers and beyond about how to get the best care as one gets older. But it’s filled with general advice for how to work with your physician to get optimal care, no matter how old you are.

Dr. Lachs begins by noting that his patients are often surprised when he tells them that he’s open to alternative therapies. In fact, he’s prescribed meditation and yoga, recommends massage, and suggests certain supplements be tried first instead of medications. His advice to his patients is critically important however: You don’t need to be defensive about alternative treatments – but you have to understand what you are taking and whether it actually works.

The first thing Dr. Lachs recommends is that you do your own research. In case you feel that’s too daunting, he reminds us that we often find researching consumer purchases, like a new car, enjoyable – so why not research alternative treatments? He suggests (as we so often also do here at EBL) that you access the scientific evidence yourself.

Dr. Lachs gives you two approaches: the easier “take-out” approach, and the “do-it-yourself” approach. If you don’t want to look up scientific articles yourself, one key source is the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health. It has lots of easily accessible information on supplements and alternative therapies. The Cochrane Collaboration is another site where you can find scientific reviews of alternative therapies.

You can also access the scientifc research yourself. But how do you evaluate the evidence you find in these articles? Here’s where Dr. Lachs really helps us. He sums up five things you need to consider (the headings are Dr. Lachs’s):

  • Make sure that what’s being studied is what you’re interested in. Sounds simple, but actually it’s how many people take a wrong turn. For example, say you want to take a supplement – you have to make sure that the research is about the same dosage and ingredients, or it may not apply to you. For something like yoga or massage, read the article carefully to see if there are other treatments involved in the study, how long people did the activity, and similar specifics.
  • Be sure the patients in the study are as like you as possible. Were the people in the study like you? Something that benefits 60-year olds may not apply to college students, and vice versa. Look for studies with people close to you in age, same gender, and other characteristics.
  • Assess the quality of the study. You can look on this site under The Learning Center for posts about evaluating study quality. Dr. Lachs notes that you should look for randomized trials, where people are randomly assigned into a group that gets the treatment or that doesn’t. Also look for how well people stuck with the therapy over time and side effects reported.
  • Look for self-effacing scientists. Good scientists talk a lot about the limitations of their studies at the end of the article. Be skeptical if the authors are too unequivocally positive about a treatment.
  • Involve your physician in this “journal club.” Talk to you doctor about what your research has found; you can even share a scientific article with him or her. Dr. Lachs says this may make your physician more amenable to trying an alternative treatment.

Here’s what I love about Dr. Lachs’s perspective: It empowers all of us patients. He encourages us to drop rigid views: either “all alternative treatments are better than regular medicine” or “all alternative treatments are garbage.” We have the power to find out the scientific evidence and share it with our physicians – and that’s a very healthy thing in and of itself!

Filed Under: Evidence-Based Living, Health and Wellness, The Learning Center Tagged With: , , ,

Professor Dan Lichter: Census drives evidence-based decisions

March 14, 2011 By 1 Comment

As the U.S. Census bureau continues to release data on state demographics, researchers, public officials and program managers across the country are digging into the new information to make decisions about everything from construction projects to quality-of-life issues and emergency services.

EBL sat down this week with Professor Daniel  Lichter, an expert in population studies and public policy at the College of Human Ecology, to talk about the 2010 census and its implications for using data to drive real-life decisions. 

Lichter called the decennial  census “the most important statistical gathering exercise in the entire United States.”  Here are some of this other thoughts about the event.

EBL: Can you describe the historical significance of the census?

Lichter:  We’ve had census every year since 1790. It’s required by U.S. Constitution.  It is conducted to insure the one person, one vote idea – to determine the number of seats each state would receive in the U.S. House of Representatives and to realignvoting districts in each state every ten years.

EBL: How has our use of the information changed over the years?

Lichter: The census is also vital for program planning and public policy. It’s always been used in some sense for those sorts of things, but it’s used now more than ever before. How do we know where to build new highways or schools or whether we need a new waste water treatment plant?

“Today, increasingly, we use census data for identifying particular populations and areas with specific needs so we can more effectively target resources to those areas.  The census is vital for earmarking public funds. It also has a huge constituency in the private sector in terms of marketing. It helps companies decide, for example, where to build new stores.

EBL: How did the 2010 census pan out?

Lichter: It’s probably the most successful census ever in terms of coverage. The census bureau has become very good at identifying hard-to-reach populations and reaching out them.

People should always fill out their census schedules when they get them because it reflects whether they’re accurately represented in Congress and whether they receive their fair share of revenues.  By law, these data are strictly confidential to insure completeness and accuracy.

(The U.S. Census Director recently spoke at Cornell about how his organization was able to collect accurate information. You can read about his talk by clicking here.)

EBL: How do you use census data in your research?

Lichter:  I’m very much interested in the changing racial and demographic composition of the U.S. population. We are almost to the point now where half of the births in the United States are to populations other than non-Hispanic whites.  We are rapidly moving toward a  majority-minority society.

I’m interested in what that means, not only in terms of educating children now, but what it means for the labor force 20 years out.  What we do or don’t do for minority populations today is going to have a major effect on our country 20 years from now.

I’m also interested in racial segregation, and to what extent racial and ethnic groups live near each other. Our population is becoming more diverse, but many communities and neighborhoods are also becoming more segregated. Some of my work tries to understand how race relations are reflected in the geographic distribution of people.

Filed Under: Evidence-Based Living, policy, The Learning Center Tagged With: , ,

Video feature: Teaching design that follows the evidence

March 2, 2011 By 1 Comment

We often think of using evidence in making medical decisions or evaluating social programs.  But is there a way to use data in a more subjective field like design?  The answer is yes!

Several decades ago, a new field called Evidence-Based Design linked the principles of evidence-based medicine with architectural and interior design to create health care facilities proven to help patients heal.  (Since then, the field has expanded to corporate environments as well.)

To date, there have been more than 1,000 academic studies that investigate design elements to make patients feel more comfortable, improve the quality and safety of health care, and create a positive working environment for health care professionals.  

One comprehensive review on the best practices is published here and includes recommendations like creating single-bed hospital rooms, using noise-deadening materials in construction, and maximizing natural light in health care facilities.

 At Cornell, faculty members in the College of Human Ecology are working on the cutting edge of this field.  They’ve investigated how the design of an intensive care unit impacts the communication among the nursing staff. And they’ve examined ways to improve the experience of people with Alzheimer’s disease living in residential facilities.

 Professor Frank Becker in the Department of Design and Environmental Analysis teaches a course that brings together students majoring in business, health care administration and design to learn about and create evidence-based health care facilities.  You can watch a video about the class below.

Here at EBL, we love it when experts in all fields discover and use evidence to improve people’s lives!

Filed Under: Evidence-Based Living, Health and Wellness, The Learning Center Tagged With: , , , ,
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