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Introducción

¿Qué deberías comer? Hay muchas afirmaciones sobre lo que se debe o no comer. Por ejemplo, hay afirmaciones sobre el chocolate que dicen que causa acné, que estimula el deseo sexual y que es bueno para el corazón. ¿Cómo puedes saber si estas afirmaciones son fiables? ¿Y cómo debes decidir cuándo actuar basándote en éstas u otras afirmaciones sobre lo que es bueno o malo para tu salud?

Hay muchas afirmaciones como esta sobre lo que es bueno para la salud. Una afirmación es algo que alguien asegura y que puede ser correcto o incorrecto.

Un “tratamiento” es algo que se hace por la salud como, por ejemplo, tomar un medicamento, hacer ejercicio, comer o no chocolate. También puede ser algo que hacemos por la salud de una comunidad, como por ejemplo, asegurarnos de que el agua es segura para beber, de que todo el mundo tiene acceso a la atención médica cuando la necesite o reducir el uso de combustibles fósiles. Un efecto es algo que sucede a causa de un tratamiento, como hacer que te sientas mejor o peor, hacer que las personas tengan más o menos probabilidades de sufrir un ataque cardíaco o un derrame cerebral, o curar a alguien que está enfermo.

Las personas hacen muchas afirmaciones sobre los efectos de los tratamientos. ¿Cómo podemos saber qué afirmaciones son correctas o incorrectas? Para saberlo, debes valorar en qué se basa la afirmación: su fundamento. Por ejemplo, la experiencia personal de alguien no es un fundamento adecuado para hacer una afirmación sobre lo que es bueno para la salud. Esto se debe a que no sabemos qué hubiera pasado si esa persona hubiera hecho otra cosa.

Para saber si un tratamiento (como comer chocolate) causa un efecto (como el deseo sexual), el tratamiento se debe comparar con otra cosa (como no comer chocolate). Los investigadores comparan un tratamiento que recibe un grupo de personas con algo diferente que recibe otro grupo. Estas comparaciones proporcionan evidencia, hechos para fundamentar una conclusión sobre si una afirmación es correcta o no. Para comparar tratamientos de manera justa (comparaciones justas), la única diferencia importante entre los grupos comparados debería ser los tratamientos que reciben.

Una buena decisión es aquella que se basa en la mejor información disponible en ese momento. En el caso de las decisiones en salud, esto incluye basarse en la mejor evidencia disponible de los efectos de los tratamientos. Las buenas decisiones no garantizan buenos resultados, pero hacen que los buenos resultados sean más probables.

Claims, comparisons, and choices

Claims: Many claims about the effects of treatments are not trustworthy. Often this is because the basis for the claim is not trustworthy. The first (pink) group of guides are things you should watch out for when you hear or read a health claim. BEWARE of claims that are too good to be true, that are based on faulty logic, or that are based on trust alone.

Comparisons: It is always a good idea to question what evidence there is to support a claim. Evidence about the effects of treatments comes from treatment comparisons. The second (yellow) group of guides can help you decide how trustworthy that evidence is. Make sure that treatment comparisons are FAIR, that summaries of studies comparing treatments are reliable, and that you are not misled by the way that treatment effects are described.

Choices: Knowing how trustworthy the evidence is can help you make good treatment choices. But there are other things you need to think about when you decide what to do and what not to do for your health. The third (blue) group of guides can help you make good choices. TAKE CARE when you decide what to do. Think carefully about what your problem is and what your options are, whether the evidence is relevant, and whether the advantages are better than the disadvantages.

Using the guides

There are endless claims about treatments in the mass media, advertisements, and everyday personal communication. This includes claims about the effects of drugs, surgery and other types of “modern medicine”; claims about lifestyle changes, such as changes to what you eat or how you exercise; claims about herbal remedies and other types of “traditional” or “alternative medicine”; claims about public health and environmental interventions; and claims about changes in how healthcare is delivered, financed and governed.

Some of these claims are true and some are false. Many are not supported by trustworthy evidence: we do not know whether they are true or false. Claims about the effects of treatments that are not supported by trustworthy evidence often turn out to be wrong. Consequently, people who believe and act on these claims waste resources and suffer unnecessarily by doing things that do not help and might be harmful, and by not doing things that do help.

We developed the Informed Health Choices (IHC) Key Concepts as the first step in a research project with the aim of helping people make informed health choices. This website includes all of the IHC Key Concepts. The IHC Key Concepts are the starting point for developing learning resources, such as this website.

The website and the poster can be used in different ways. For example, by finding examples of treatment claims in the media and – using the guides – thinking critically and discussing how trustworthy those claims are and what you would do. For each concept, we have provided links to examples and some additional learning resources.

Please contact us and share your experience using this website and any suggestions you have.

Other resources

The Health Choices Book includes a comic story that introduces and explains 12 Key Concepts. It is written at a primary school level. The book and other learning resources can be found on the Informed Health Choices website.

Testing Treatments international provides open access to the book, Testing Treatments, which can be read online, listened to, or downloaded. The book explains most of the Key Concepts in plain language using examples.

The goal of Know Your Chances is to help you better understand health information by teaching you about the numbers behind the messages—the medical statistics on which the claims are based.

Smart Health Choices aims to help consumers and practitioners develop the skills to assess health advice – and to make decisions that will improve the quality of their care.

The Learning Resources Database provides a platform for sharing learning resources for teaching and learning Evidence-Based Health Care (EBHC). The learning resources can be searched and filtered by the Key Concepts, the target audience, and the format.

GET-IT stands for the Glossary of Evaluation Terms for Informed Treatment choices. The aim of this glossary is to facilitate informed choices about treatments by promoting consistent use of plain language and providing plain language explanations of terms that people might need to understand if they wish to assess claims about treatments.