What we do

Second opinion

Why we do what we do

Our vision is a world of improved health where decisions about health and health care are informed by high-quality, relevant and up-to-date synthesized research evidence.

Our Mission

Our mission is to promote evidence-informed health decision-making by producing high-quality, relevant, accessible systematic reviews and other synthesized research evidence.

Our Vision

Our vision is a world of improved health where decisions about health and health care are informed by high-quality, relevant and up-to-date synthesized research evidence.

Question. Everything.

Creating systematic reviews or critical literature reviews regarding different health related topics.

Question.Everything. is an independant non-profit project that aims to research and provide more in depth analysis to allow decision making. We are science driven and will look at both sides of things. We often read hundreds and hundreds of articles before we write our conclusions. Any conclusions provided in an article or blog post is aimed to understand the topic in depth. There is no one-size fits all. Every human is different and any decisions is personal.

FOR HEALTHCARE PROVIDERS:

Some answers and posts may differ from what you (and I) learned in school. As a pharmacist, I believe I can have an influence and I make sure my articles express facts. Your clinical judgment, experience, and comments are more than welcome! Don’t hesitate to contact us if you wish to share your thoughts or join as a collaborative volunteer.

METHODS AND IMPORTANT CONSIDERATIONS

Reading on the internet is more complicated than you may believe. A scientific article does not mean truth. A blog post doesn’t either. This is not a class on how to understand what we read and analyze scientific research (this required more studies and graduate degree classes), but here are a few points to explain what we mean:

Confirmation bias: This cognitive bias is the tendency to look for, to search or interpret information that supports or confirms our prior beliefs or values. Our brains are full of beliefs either from school, culture, or anything else. This can lead to distortion of evidence-based decision-making in a society.1 If you are looking for a side effect, you will put all your efforts towards this research, and may pass all the other potential side effects or benefits. You won’t realize you are doing this, it’s unconscious.

During our research work, we aim to reduce this bias by looking for contradictory information and questioning concepts we initially believed, or questioning previously established thought or confirmed information. This is a skill that was developed by Dr Stephanie El-Chakieh, pharmacist. It requires courage to question things we even read in books for the purpose of clarity.

Confounding bias: This is the result of ‘‘mixing of effects’’. When trying to understand a cause or what lead to an effect, e.g. this vaccine caused XYZ side effect, or the opposite, this vaccine prevented ABC disease, it is important to consider all possibilities that could have led to the result. Are we assessing other risk factors of XYZ or positive factors to reduce ABC disease? 2

A more specific example:

Cervical cancer increases with the contraceptive pill, and this is reversible once stopped.3 (p.s. the pill also protects from other cancers, this is only one example and is not a recommendation or advice). In a study assessing the effectiveness of Gardasil (r) 9 or other HPV vaccines, they should assess if the subjects stopped or changed contraceptive method. If stopping the pill can reduce cervical cancer, and this is not measure int he study, we don’t know if the vaccine is really effective, or if there were other confounding variables not considered. There is possibility of confounding biases when other factors are not taken into account, and could be the cause or contributing factors to the measured effect. Unfortunately, this happens quite often in clinical trials. Randomization (when subjects are randomly place in groups) is not sufficient. The confounding variables should be established before a study and stratification should be done in the study. Otherwise, the results will be biased, establishing an untrue association link. This again leads to distortion of the outcome.

We try reducing this bias by exploring all the identified risk factors before starting our research, in order to understand what is appropriate, and what cannot be concluded.

Methodology: When reading an article, it is also important to evaluate the methodology chosen by the authors. In other words, not believing that what you are reading is appropriate. It requires critical thinking, but also previous knowledge in what is considered appropriate or not. Things get complicated, and I don’t want to overwhelm you. I just wish to make you realize that ‘‘scientific article’’ does not = proven, good, or anything else before it was analyzed.

We have a holistic approach, meaning that we view things as a hole, not a collection of parts. We asses all the possible known factors, risks, ethics, benefits, costs, etc.

Conflict of interest: https://www.cochrane.org/MR000047/METHOD_financial-conflicts-interests-and-results-conclusions-and-quality-systematic-reviews

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Disclaimer: The articles are written by myself and do not, in any case, replace your healthcare provider’s recommendations. For appropriate care, a throughout analysis needs to be conducted. You may agree or disagree, and as a pharmacist, I have a responsibility to share the truth, which I consider my truth. Because truth is also subjective. For more details, see Disclaimer.