MS Speaks

Medical Evidence Scant for Much TV Docs' Advice

Recommendations from Dr. Oz and his telegenic colleagues are often baseless.

by Molly Walker
Contributing Writer, MedPage Today

With readily available daily appointments, a nicer exam room, and no copay, it's no wonder TV doctors have so many patients under their care. But consumers should know that, about half the time, the televised advice has no firm scientific basis, according to a new study.

Among health recommendations from "The Dr. Oz Show" and "The Doctors," only 54% (95% CI 47%-62%) was supported by actual medical evidence, reported Christina Korownyk, MD, from University of Alberta in Canada, and colleagues.


The remainder didn't have so much as a case study for support. No evidence at all was found for 33% of health claims made on "Dr. Oz" and 24% of recommendations made on "The Doctors," they wrote in BMJ as part of the journal's annual, not entirely serious Christmas edition.

Korownyk said the study provides a "baseline" for non-TV doctors to discuss these medical talk shows with their patients.

"These shows can be quite charismatic and entertaining, and maybe people aren't even thinking about those things," she said. "This [study] just gives clinicians a starting point to have that discussion with their patients and say 'Well, you know, maybe not everything is completely evidence-based on those shows.'"

Her group recorded all episodes of "The Doctors" from Jan. 11 to May 1, 2013 and all episodes of "Dr. Oz" from Jan. 7 to May 1, 2013. They randomly selected 80 episodes total (40 of each show) and analyzed 158 recommendations (for a 95% CI with a precision of +/-10%).

Then 160 (80 apiece) of the strongest recommendations were selected, and two healthcare professionals searched Pubmed/Medline, Embase, Cochrane Database of Systemic Reviews, Natural Standard Database, and Google to determine if evidence existed for a recommendation. They deemed "evidence" to be a clinical study -- a case report or better. Animal research did not count.

While "The Doctors" gave evidence-based medical advice 63% of the time, less than half (46%) of the advice made on "Dr. Oz" could be validated. But even when a claim could be verified with evidence, the shows seldom described the "magnitude of benefit" of these recommendations -- only 17% on "Dr. Oz" and 11% on "The Doctors."

"Looking at specific benefits, harms and costs is a pretty important part in regards to educating patients," Korownyk pointed out.

Any potential harms of the recommendation were mentioned less than 10% of the time (9.8% for "Dr. Oz" and 7.6% for "The Doctors"). Korownyk cited that lack of detail as a reason clinicians need to encourage their patients to be skeptical about claims on these shows.
"Having a woman come on a show and saying that she took her son off [foods made from genetically modified crops] and [that] cured his autism is very dangerous. It gives people false hope," added Joseph Perrone, ScD, chief science officer for the Center for Accountability in Science in Washington, D.C., who was not involved with the study.

Limitations of the study include the fact that the protocol for the study had to be modified several times, so the researchers could best capture the content of these shows using the appropriate quantitative method. Also, Korownyk pointed out researchers did not do a systematic review of the recommendations "because that would've taken the rest of our lives."

Medical talk shows continue to be both popular and influential among viewers. Both shows boast an average audience of over 2 million daily viewers, with "Dr. Oz" ranking among the top five most-watched talk shows from 2012-2013.

In addition, both Mehmet Oz, MD, and "The Doctors" host Travis Stork, MD, were included in a 2012 report of the top 100 health and fitness influencers by Greatist, a health and fitness website, the authors wrote.

Since it seems unlikely that referrals from the television will stop anytime soon, clinicians will likely be forced to continue re-educating their patients.

"I can make some anecdotal evidence that if I eat ginkgo biloba, my brain power may be increased, but the NIH ... a few years ago did a very detailed study on ginkgo biloba and found that in fact there was no increase in brain power associated with it at all," Perrone said.

Perhaps the best advice non-TV doctors can give about the medical talk shows? "Turn off the television and call me in the morning."

This study was supported in part by the David and Beatrice Reidford Research Scholarship through the University of Alberta.

Korownyk and co-authors disclosed no relevant relationships with industry.

Ivan Oransky, MD, MedPage Today vice president and global editorial director, served as a reviewer for this study.


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Primary Source
British Medical Journal

Source Reference: Korownyk C, et al "Televised medical talk shows -- what they recommend and the evidence to support their recommendations: a prospective observational study" BMJ 2014;349:g7346.

Should You Listen to Dr. Oz?

by JOHN SWARTZBERG, M.D.

If a doctor says something on television, it must be true—right? Not so fast. Actually, much of the medical advice dispensed by TV celebrity doctors is questionable, to say the least. (I'm talking about real doctors here, not actors who play doctors on TV.) Over the past several years, we've called attention in particular to Dr. Mehmet Oz, who makes recom­mendations that are often wacky or downright wrong—and risky. In 2014 a Senate panel harshly admonished him for making unsubstanti­ated weight-loss claims and touting dubious products on his show. More recently, a group of 10 doctors from around the country called for Dr. Oz to be removed from the faculty of Columbia University, where he is vice chair of the Department of Surgery, citing his promotion of "quack treatments and cures," among other offenses.

In one episode, for instance, Dr. Oz gave a thumbs up to green cof­fee extract as a "miracle" weight-loss pill—though of course if it were a real "miracle," there would be no need for him to plug so many other weight-loss supplements (like the "belly-blaster" 7-Keto) on other epi­sodes. Want a natural sweetener that can help prevent the sugar crashes that make you feel hungry and cause you to gain weight? Coconut sugar is it, Dr. Oz said on another episode—though there's no evidence to support these claims, and coconut sugar has as many calories as regular sugar. What about a natural tooth whitener? Dr. Oz recommended lemon juice and baking soda, but the mixture doesn't stay on teeth long enough to have a whitening effect. And as he him­self acknowledged, the acid from the lemons can erode tooth enamel if left on too long.

With his charisma, good looks, and enthusiasm, the scrubs-wear­ing Dr. Oz certainly puts on a good show. Entertainment it is indeed; good medical advice it often is not. That's why I was glad to see a recent study in the medical journal BMJ that, for the first time, system­atically analyzed the recommendations and claims made on The Dr. Oz Show (the most popular syndicated medical talk show), along with those on The Doctors (the second most popular). Researchers watched 40 episodes of each show from 2013 and then had independent review­ers search medical databases to find published studies that supported the recommendations being made. Little surprise, of 160 recommen­dations, about half had no supporting evidence or ran contrary to the best evidence available. The Doctors fared a bit better, with 63 percent of the recommendations backed by evidence versus 46 percent on the Dr. Oz Show.

Especially disturbing was that the shows mentioned potential harms less than 10 percent of the time and almost never declared potential conflicts of interest. The study noted that the recommendations were often given by guests on the show, not the doctors themselves. Still, to the average viewer, I doubt this distinction matters much in terms of how believable they seemed, since a guest's recommendation carries the implicit endorsement of the doctors, especially when they sit there nodding their heads.

This was an important study, given that these two programs reach more than 5 million people a day, dishing out an average of 23 health-related recommendations daily. For many viewers, these shows are their primary (or even sole) source of medical information.
Though Dr. Oz and the hosts of The Doctors seem trustworthy and sometimes do give good advice, you should be skeptical about what you hear on their shows. After all, their primary mission is to get people to tune in, not to make them healthier. If a medical product or remedy discussed on TV—or discussed anywhere, for that matter—is of interest to you, my advice is that you research it yourself (and not just on the web­sites promoting it). Then seek a second opinion—from your own doctor.