The researchers analyzed 160 randomly selected medical recommendations and claims made from January to May 2013 on two of the most-viewed daytime talk shows on American television: “The Dr. Oz Show” and “The Doctors.”
They found that only 46 percent of the recommendations on “The Dr. Oz Show” were supported by any scientific evidence, and even fewer — 33 percent — were supported by believable, or high quality, evidence. Another 39 percent of the advice meted out on that show had no evidence to back it up, and about 15 percent was actually contradicted by the published evidence.
“The Doctors” did slightly better. Some 63 percent of its recommendations were evidence-based, and 53 percent were supported by believable evidence. Yet 24 percent of the advice extolled by its hosts and guests lacked any supportive evidence, and 14 percent was contradicted by the published research.
In other words, the study found no evidence for slightly more than 1 in 3 of the recommendations for “The Dr. Oz Show” and 1 in 4 recommendations for “The Doctors” — “despite us being quite liberal in the type and amount of evidence we required,” write the study’s authors.
Harms and conflicts seldom mentioned
Both talk shows are quite eager to dispense advice. “The Dr. Oz Show” averaged 12 recommendations per episode, and “The Doctors” averaged 11, the study found. Dietary recommendations (such as “Carb load your plate at breakfast”) were the most common type of advice (39 percent) on “The Dr. Oz Show.” On “The Doctors,” the most frequently given advice (18 percent) was to see a healthcare provider (such as “Go to your primary care doctor or talk to their nurse before going to the ER to help relieve the load in the ER”).
Interestingly, dietary recommendations were eight times more common than exercise recommendations on “The Dr. Oz Show” and two times more common on “The Doctors.”
Only about 40 percent of the recommendations on both shows explained how the advice would benefit individuals, and the actual amount of benefit from the advice a person might expect to receive (the absolute versus the relative benefit) was mentioned less than 20 percent of the time.
Perhaps most troubling was the finding that harms associated with the recommendations were mentioned less than 10 percent of the time, and costs were mentioned less than 15 percent of the time.
“Thus, anyone who followed the advice provided would be doing so on the basis of a trust in the host or guest rather than through a balanced explanation of benefits, harms, and costs,” write the authors of the study.
Disclosures of potential conflicts of interest by the people or groups making the recommendation were made less than 1 percent of the time on both shows.
The importance of conversation
Of course, as the authors of this study point out, it’s difficult to know how much medicine practiced by doctors in “the real world” is evidence-based. A review published over a decade ago estimated that about 78 percent of medical interventions had “compelling” evidence to back them up.
Nor do all “real-world” doctors always give their patients a full benefits-versus-harms breakdown for the procedures and treatments they recommend — or a full description of any and all potential financial conflict-of-interests they may have in regards to those procedures and treatments.
Still, you can talk with your doctor — unlike with a TV talk show host — to make sure you get the information and transparency you need. “Decisions around healthcare issues are often challenging and require much more than non-specific recommendations based on little or no evidence from media health professionals,” write the authors of the BMJ study. “Patients would do well to ask healthcare providers specific questions about the benefits and harms, along with the magnitude of the effect (in absolute numbers), and the costs and inconveniences of any recommendations.”
You can read the study on the BMJ website.