Objective To determine the quality of health recommendations and claims made on popular medical talk shows.Design Prospective observational study. Setting Mainstream television media. SourcesInternationally syndicated medical television talk shows that air daily (The Dr Oz Show and The Doctors). Interventions Investigators randomly selected 40 episodes of each ofThe Dr Oz Show and The Doctors from early 2013 and identified and evaluated all recommendations made on each program. A group of experienced evidence reviewers independently searched for, and evaluated as a team, evidence to support 80 randomly selected recommendations from each show. Main outcomes measuresPercentage of recommendations that are supported by evidence as determined by a team of experienced evidence reviewers. Secondary outcomes included topics discussed, the number of recommendations made on the shows, and the types and details of recommendations that were made. ResultsWe could find at least a case study or better evidence to support 54% (95% confidence interval 47% to 62%) of the 160 recommendations (80 from each show). For recommendations in The Dr Oz Show, evidence supported 46%, contradicted 15%, and was not found for 39%. For recommendations in The Doctors, evidence supported 63%, contradicted 14%, and was not found for 24%. Believable or somewhat believable evidence supported 33% of the recommendations on The Dr Oz Show and 53% on The Doctors. On average, The Dr Oz Show had 12 recommendations per episode and The Doctors 11. The most common recommendation category on The Dr Oz Show was dietary advice (39%) and on The Doctors was to consult a healthcare provider (18%). A specific benefit was described for 43% and 41% of the recommendations made on the shows respectively. The magnitude of benefit was described for 17% of the recommendations on The Dr Oz Show and 11% on The Doctors. Disclosure of potential conflicts of interest accompanied 0.4% of recommendations. ConclusionsRecommendations made on medical talk shows often lack adequate information on specific benefits or the magnitude of the effects of these benefits. Approximately half of the recommendations have either no evidence or are contradicted by the best available evidence. Potential conflicts of interest are rarely addressed. The public should be skeptical about recommendations made on medical talk shows.Additional details of methods used and changes made to study protocol

BackgroundWhile journals and reporting guidelines recommend the presentation of confidence intervals, many authors adhere strictly to statistically significant testing. Our objective was to determine what proportions of not statistically significant (NSS) cardiovascular trials include potentially clinically meaningful effects in primary outcomes and if these are associated with authors’ conclusions.MethodsCardiovascular studies published in six high-impact journals between 1 January 2010 and 31 December 2014 were identified via PubMed. Two independent reviewers selected trials with major adverse cardiovascular events (stroke, myocardial infarction, or cardiovascular death) as primary outcomes and extracted data on trial characteristics, quality, and primary outcome. Potentially clinically meaningful effects were defined broadly as a relative risk point estimate ≤0.94 (based on the effects of ezetimibe) and/or a lower confidence interval ≤0.75 (based on the effects of statins).ResultsWe identified 127 randomized trial comparisons from 3200 articles. The primary outcomes were statistically significant (SS) favoring treatment in 21% (27/127), NSS in 72% (92/127), and SS favoring control in 6% (8/127). In 61% of NSS trials (56/92), the point estimate and/or lower confidence interval included potentially meaningful effects. Both point estimate and confidence interval included potentially meaningful effects in 67% of trials (12/18) in which authors’ concluded that treatment was superior, in 28% (16/58) with a neutral conclusion, and in 6% (1/16) in which authors’ concluded that control was superior. In a sensitivity analysis, 26% of NSS trials would include potential meaningful effects with relative risk thresholds of point estimate ≤0.85 and/or a lower confidence interval ≤0.65.ConclusionsPoint estimates and/or confidence intervals included potentially clinically meaningful effects in up to 61% of NSS cardiovascular trials. Authors’ conclusions often reflect potentially meaningful results of NSS cardiovascular trials. Given the frequency of potentially clinical meaningful effects in NSS trials, authors should be encouraged to continue to look beyond significance testing to a broader interpretation of trial results.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-017-0821-9) contains supplementary material, which is available to authorized users.

New Findings r What is the central question of this study?Do plasma concentrations of oestrogen and progesterone similar to those observed near the term of pregnancy alter basal core temperature or the core temperature response to bacterial pyrogen in oophorectomized rats? r What is the main finding and its importance?Plasma concentrations of oestrogen and progesterone similar to those observed near the term of pregnancy do not alter basal core temperature or the overall febrile response to bacterial pyrogen in oophorectomized rats. Thus, our data do not support the hypothesis that sex steroids mediate the regulated decrease in basal core temperature or the attenuated/absent core temperature response to bacterial pyrogen observed in rats near the term of pregnancy.Fever, an important component of the host's defence response to infection, is absent or attenuated in rats near the term of pregnancy concurrent with major changes in blood concentrations of the sex steroids, oestrogen and progesterone. The present experiments were carried out to determine the potential role of oestrogen and progesterone in mediating the altered core temperature response to bacterial pyrogen. For the experiments, oestrogen and progesterone were administered alone or in combination to oophorectomized, non-pregnant rats in concentrations that mimicked plasma levels of these hormones measured in pregnant rats on days 17, 18, 19 and 20 of gestation. Treatment with oestrogen or progesterone alone or in combination did not alter basal core temperature or the overall febrile response (i.e. 12 h fever index) to an EC 50 dose of Escherichia coli lipopolysaccharide (i.e. 20 µg kg −1 ). Administration of oestrogen did, however, influence the early core temperature response and increase the latency to fever following administration of lipopolysaccharide. Thus, our data provide evidence that although oestrogen may influence the early core temperature response to lipopolysaccharide, sex steroids in concentrations similar to those observed late in gestation do not alter the overall febrile response and are therefore unlikely to mediate the attenuated or absent febrile response to bacterial pyrogen in rats near the term of pregnancy.

What is the efficacy of antibiotic prophylaxis for recurrent urinary tract infections (UTIs) in nonpregnant women?