Nancy Wight did a big job for us in presenting the findings from Schanler's
article more thoroughly and in a more nuanced way, than previously done on
this list.  I for one am grateful for what amounted to a short expository
lecture about the study, by someone whose expertise is beyond doubt.
Any of you who have had something you have done, get mass media coverage,
will be familiar with the phenomenon of sensationalization.  It is highly
unlikely that the authors had any say in the way the results were presented,
and journalists may or may not have the necessary background to read the
original study in a critical way.  In my experience, popular press versions
of research are prime examples of 'dumbing down', as normally only one thing
will be emphasized, and it will be presented in a very black and white way,
suitable for a sound bite in between the cat food ad and the weather report.
Also, as Nancy points out, the ONLY acceptable way to treat results in a
randomized controlled study, is to analyze them by 'intent to treat'.  That
means that if a person is randomized to get one treatment, they will be
counted in the group that got that treatment, even if for some reason they
did not get it.  If you are having a hard time understanding why this is so,
you are not alone.  Even editorial boards of reputable medical publications
have had difficulty getting this through their heads in the past, and a lot
of good research went begging for publication because the researchers simply
were too stringent and were ahead of their time.  There is no hocus-pocus
involved, but you do need to have a basic understanding of statistical
methods as applied in RCTs.
It is also becoming less and less acceptable for a researcher not to account
for attrition, or to make clear how many people who were randomized to each
treatment, actually got it.  Transparency is the word here - a reader ought
to be able to reconstruct the study from the data presented in the report.
I haven't read the article yet, but since so many readers here have
discovered so much about the babies in the study, it seems Schanler has
respected the need for transparency, and that increases the credibility of
the research, rather than reduces it.  
We have to take it seriously, and read it critically as we should any
research - **especially** (shouting now) research whose conclusions support
what we already believe!!   But we need to guard against rejecting a paper
out of hand simply because one or more of the conclusions is at odds with
our beliefs.
Research is slow and painstaking and hardly EVER does a single study lead to
sweeping changes in practice, nor should it, as a rule.  Each published
report will at best add something new, raising new questions about what the
next thing is we should look at, and the body of knowledge grows
accordingly.

Rachel Myr
Kristiansand, Norway

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