A Second Look: The Difficult Problem of Interpreting Science
Studying scientific research is complicated by so many things.
First of all, humans don’t live in test tubes. There are so many other factors that affect their lives. Second, the people who do the research don’t always make it easy to understand what they have done. Third, sometimes, there are willful attempts to falsify the results. You may remember that the fake studies linking autism to vaccines was prompted by a lawyer who wanted to make money suing pharmaceutical companies. The result was that frightened parents delayed vaccinating their infants and some died. Let’s look at another example that is ongoing.
Since the 1980s, there have been studies looking at the effect of certain medications taken by pregnant women on the brain development of their offspring. You can see the parallel here: the payoff for lawyers who can convince juries of the validity of their cases is huge. And remember that lawyers don’t have to prove that their case is scientifically accurate. The other complicating factor is that a certain number of children will have neurologic disorders, whether the mother is on medication or not. Showing a statistical difference can be very challenging. I warn you that there is a lot of information online that is very frightening but not accurate.
If you search “Tylenol and autism,” you will find a number of articles – and many attorneys – encouraging you to pay attention to their arguments. The actual science, however, is very weak. I bring this up because the information shows up on Facebook and other non-scientific social media sites. I have been looking at this issue for a while. The most important research was published in March of this year after many years of data were evaluated. This is the conclusion: There is currently no strong evidence that acetaminophen use during pregnancy causes autism or ADHD in children. Expert groups continue to recommend the use of the drug during pregnancy when necessary and in consultation with a doctor.
I present this information both to reassure you and to remind you that Dr. Google is not necessarily your best source of information. If you have questions about something you heard or read, ask your pediatrician. You can also write to me in care of the Tribuna, and I will be glad to help. I cannot answer specific questions about your child’s health, of course.
Now, I want to tell you about some research that should make you think. It concerns head injuries incurred by children playing contact sports. Young adults who had died from various causes and who played contact sports in youth, high school, or college teams were studied. Almost half had mild evidence of chronic traumatic encephalopathy (CTE), which in professional football players in particular has been associated with serious brain damage and sometimes premature death. Almost all of the young adults with CTE were symptomatic, but so were some of the people who didn’t have CTE, so it’s not clear how significant these findings are. The conclusion was that the symptoms, including mood and behavioral changes, were common to athletes who played contact sports, and these symptoms are reversible with proper care and management. We still don’t really know if mild brain damage is reversible or if it will get worse as the patient gets older.
Other studies looked into the more specific question of recovery after concussion. One article concludes, “[There is] no evidence of clinical meaningful differences in IQ after pediatric concussion.” Another suggests that slow recovery may be related to other factors not recognized prior to the head injury, like anxiety.
What is important here is that while we are no longer ignoring the possibility of long-term damage from children’s head injuries, we are not exaggerating the possibilities either. In particular, children who continue to have headache or fatigue should continue to be monitored. Talk to your pediatrician. Your child can be referred for specialty evaluation. The question of whether your child should return to sports is not a simple one, and you can get help with your decision.
Robert B. Golenbock, MD, is currently retired. He has cared for children in the Danbury area for 43 years, including at the Center for Pediatric Medicine. The CPM is located at 107 Newtown Rd, #1D, Danbury, CT, 06810. For more information, please call (203) 790-0822 or visit https://centerforpediatricmedct.com.