The article I have chosen for my science in the popular media evaluation comes from CBSnews.com. The article is titled Statins Sometimes Raise Stroke Risk, Study Says: Who’s at Risk? From an average readers perspective this is an important article concerning those who have had or at risk of having a stroke. Statins such as Lipitor, Zocor, and Crestor are drugs used to lower bad cholesterol. Since bad cholesterol is often associated with strokes, many patients who have had strokes have taken statins to lower their cholesterol in the hopes of preventing another stroke. However, Dr. M Brandon Westover believes that doctors should use caution in giving a statin to people who have had bleeding in the brain due to a stroke. Doctors who researched these findings stated that statins might prevent clotting in the brain if another stroke occurs in a patient. These findings are supported by Dr. Larry Goldstein who accompanied the study. The paper states that, “In the absence of new data to the contrary, statins should generally be considered off-limits to these patients.
Looking at this article, a reader may take the assumption right away that statins are drugs that should be avoided if they have already had a stroke. The work was done by a respectable Massachusetts General Hospital Doctor with the support of a prestige Duke University doctor. One of the doctors even came to the conclusion that, “doctors shouldn’t prescribe statins to people who have suffered an intracerebral hemorrhage.” The work is also published in the May issue of “Archives of Neurology”, a respectable journal. They also point out what they think is the reasoning behind the dangers of statin usage. From an average reader, this must be a pretty conclusive article about the dangers of statin use in post-stroke patients.
On the other hand, there are many flaws in this article to validate it from a scientific perspective. When looking at a science article, one must look at the methods of how the research was conducted. In other words, how did these doctors come up with this conclusion that statin use is dangerous for patients who have had a stroke? To be honest, there is little if any methods expressed in this article. The only statement that this article made concerning how this research was conducted was that, “He (Dr. Westover) said the computer model at the core of his research suggested that whether statins make sense may depend on the location of the intracerebral hemorrhage. Absolutely no data or even layman numbers were given in this article. The questions that a scientist could ask about this research article are close to endless: What software was used in this model? How was this research conducted on this software? What was the size of your sample? What were the sample’s age, gender, and overall health? How were these samples chosen? Were there any controls or placebos? Was there any sort of hypothesis or prediction leading into this experiment? At what dosage were the statins given? How often were the statins given? Some if not most of these questions need to be answered to make a complete assessment of this research. The questions of sample size and diversity of the sample are needed to validate this experiment to see if the researchers ran enough trails and if they did not test a certain group of people such as age. More precise questions such as the usage of a control/placebo or hypothesis asked the question of if there were other factors involved in the usage of statin or not, including possible bias from the doctors. This bias could go as far as if these doctors have a personal view against these drugs (a less obvious question, but a question to ask none the less). There is also no counter argument against this statement or citation of any other work done in this field of research to support the doctor’s claim. Overall I believe that this article was good at giving bold statements, but lacked the substance of how they arrived at those answers to validate these statements.
I believe that the information given in this article is exaggerated. Looking back, the base case for the computer analyses was a 65-year-old male intracerebral hemorrhage survivor. I believe that a large diverse sample would yield more confident results than one older male. They then based their results on quality-adjusted life expectancy in which they projected how many more years their patient would live if they took statins and if they did not take statins. Most of the projections supported the fact that not taking statins did increase the life expectancy to around 2-2.5 years in outer brain hemorrhaging. However, when they tested hemorrhaging deep in the brain, taking statins only shortened a projected lifespan of 0.8 years. Even in the comments section, the authors discussed the limitations of their work, including only using a single clinical trial and only using an all-or-none strategy in which they did not mix some statin use along with other therapies in patients. Although this research paper does include results against the use of statins, I believe other tests of other designs are needed before the media writes a report on the evils of this drug on stroke patients. I believe that this story was slightly exaggerated due to the writer either putting too much faith into this one article’s truthfulness, or the need to write a paper worthy to be put onto CBSnews.com. After all, it is there job to write a paper in which people will want to read (biasness at work here?)
So what should we do to validate or reject the notion that statins are unsafe in patients who have suffered from a stroke? This question is quite difficult due to the nature of this experiment. The obvious experimental design would be to gather a large and diverse sample of patients who have already suffered an intracerebral hemorrhage. Because the article and the research states that there statins may have different effects depending upon the location of the hemorrhage, the sample should include as many different hemorrhage areas as possible. Then, you can run a double blind experiment and give one section of the sample a statin, either specifically using one of the major statins (Lipitor, Zocor, and Crestor) or all three. The other group is given a placebo. Then observe the short and long term effects of the statins to see if the data shows any significant difference in the amount of second strokes between the two groups.
Now I may not have taken an ethics course, but I do understand the underlying problem that this method might kill our patients, something we as researchers are not out to accomplish. Other possible ideas are to run trials on lab rats (how you would get them to have a stroke in this first place is beyond my knowledge). You could also study and research the actual drug itself. A researcher could break down the components of the drug to see its possible effects on the body, especially its anti-clotting abilities that could prevent clotting in a intracerbral hemorrhage. Another possible area of research is to test the effects of certain statins in small amounts along with other procedures to reduce the risk of high cholesterol and another stroke. Restated, more tests (and different designs of tests) are needed to either validate or reject this notion that statins should be entirely avoided in patients with stroke histories.
Literature Cited
Freeman, D (Writer). (2011,January,11). Statins sometimes raise stroke risk, study says: who's at risk [Television series episode]. In (Executive producer), CBSnews.com. CBS. http://www.cbsnews.com/8301 504763_162-20028116 10391704.html
Westover, B, Bianchi, M, Echman, M, & Greenberg, S. (2011). Statin u following intracerebral hemorrhage. Archives of Neurology, Retrieved from http://archneur.ama assn.org/cgi/content/full/archneurol.2010.356
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