Televised medical talk shows - health education or entertainment?

For millions of people around the world, televised medical talk shows have become a daily viewing ritual. Programs such as The Dr. Oz Show and The Doctors have attracted massive followings as charismatic hosts discuss new medical research and therapies while offering viewers their own recommendations for better health. For show producers it's a winning ratings formula, but for viewers eager for a healthier life, the results aren't so clear cut.

"The research supporting any of these recommendations is frequently absent, contradictory or of poor quality," says Christina Korownyk, an associate professor in the Department of Family Medicine in the University of Alberta's Faculty of Medicine & Dentistry.

"The public may see these shows as educational," adds Mike Allan, a colleague and fellow professor in the Department of Family Medicine. "But in many ways we wonder if that's really what they're there for and perhaps they're just there for entertainment."

Korownyk and Allan are two of the authors of a new study published in the Christmas edition of the British Medical Journal, which examines the recommendations of televised medical talk shows. The researchers say they settled on the study after hearing concerns from several physicians whose patients took to heart the advice given on the shows.

"Some patients come in and say 'I heard on Dr. Oz yesterday that we should all be doing this.' And then we're left scrambling in our office to try to find answers," says Korownyk. "It got us reflecting, what's being said there? What kinds of things are being recommended and what kind of information is being provided?"

To find an answer, the team chose two internationally syndicated medical talk shows to analyze: The Dr. Oz Show and The Doctors. Each show was recorded every day from January 2013 to April 2013. From there, the researchers randomly selected 40 episodes of each show and had two team members watch every episode independently, recording topics, recommendations made and who was making the recommendations. After that, another two researchers were brought in to re-watch the episodes, focusing on the information provided in the recommendations and answering the questions: was there a benefit mentioned? Was it specific? Did the show quantify the magnitude of the benefit? Did they mention costs? Did they mention conflict of interest?

The team then randomly selected 80 of the strongest recommendations from each show for further study, giving the medical researchers an hour per question to try and find out if there was any evidence to support what was being said. Korownyk says the results were revealing.

"One out of three recommendations from The Dr. Oz Show has believable evidence and about half of the recommendations on The Doctors has believable evidence."

"Frequently you're not getting enough information and without doing the research you won't know if it's supported by evidence or not," adds Allan.

Among the other findings:

Most common topic discussed after general medical advice:

• The Dr. Oz Show - Dietary advice (43.2 percent)
• The Doctors - Dietary advice (16.8 percent)

Most common recommendations given:

• The Dr. Oz Show - Dietary advice (39.2 percent)
• The Doctors - Consult a health-care professional (17.8 percent)

Were specific benefits mentioned along with the recommendation?

• The Dr. Oz Show - (42.6 percent)
• The Doctors - (41.3 percent)

Was the magnitude of the benefit mentioned with the recommendation?

• The Dr. Oz Show - (16.5 percent)
• The Doctors - (11 percent)

Were possible harms mentioned?

• The Dr. Oz Show - (9.8 percent)
• The Doctors - (7.6 percent)

Were costs mentioned?

• The Dr. Oz Show - (12.5 percent)
• The Doctors - (3.1 percent)

Korownyk and Allan also note that out of 924 total recommendations examined, in only four instances were there accompanying mentions of potential conflict of interest by the presenter. Allan believes the sum of evidence shows viewers aren't being given enough information to make the best decisions.

"It is limited and would not allow many patients to make a clear informed choice about what they're hearing. They're really taking these recommendations based on their trust of the host rather than making an informed choice based on the information provided."

The researchers say it appears that general advice for the public is often not the best path for viewers to make their health decisions. And while televised medical talk shows may be great entertainment, listening to health-care providers who can give specific and balanced advice will leave people healthier and happier in the long run.

"Our bottom line conclusion is to be skeptical of what you hear on these shows," says Allan.