Don’t Get Pinched: How to Spot "Crabby" Research
Imagine you’re scrolling through your feed late at night and you come across something you think might help your patients. You come across a sleek infographic from an influencer claiming that a specific raw juice cleanse is the "miracle cure" for GERD. It has thousands of likes, glowing testimonials, and the author looks like a picture of perfect health.
You feel like this might be good to run by your patient. After all, if this is something that could help them, shouldn’t you let them know about it? But then you second-guess yourself. Is this person actually an expert? Why am I even listening to them? Should I just assume they know what they’re talking about just because they’ve got a smile that can light up a room?
We’re smack dab in the middle of the age of information. Which means that most of it is abundant, readibly available… and cheap. Because of this, it’s important that we be extra cautious of the things we read— especially on social media!
Part of our job is to scrutinize the literature to filter out the bad and bring the good to our patients. We’re on the front lines, keeping our patients safe from risky devices or treatments that could make their therapy filled to the brim with nonsense and their wallets empty of cash.
In with the good and out with the bad. It’s good dieting advice. And times like these, where there is a plethora of junk jargon trying to pass as well-founded literature, I think we’re all in need of a diet. This is why Dr. Jessica Stokes-Parish and her colleagues developed a simple tool to help you determine whether a message is worth listening to or whether it's better to shut it down and warn the others.
Introducing the CRABS Framework
At the height of the COVID-19 pandemic, the internet was flooded with conflicting health information. People were anxious about the present and fearful about the future. A dangerous combination for snake-oil salesmen to pop up everywhere. To help the public navigate this, Dr. Stokes-Parish introduced the CRABS mnemonic—a five-step checklist to determine if the research claim you’re looking at is actually credible.
Oh, and how I love a good mnemonic. Here it goes…
C — Conflict of Interest
Does the person sharing the information stand to gain anything? Do they own the company that produces the supplements they’re recommending? Are they being paid to promote a "cure," whether or not it works? Sometimes it’s subtle—like a practitioner who only shares research that supports their own product and ignores conflicting literature. But the message here is clear. If there is money on the table, then that message needs to be interrogated fiercely.
R — References
Where are the receipts? Reliable data should be backed by quality data. Check whether any literature is being cited, then go directly to the source to ensure it is relevant and up to date. How long ago was it published (science moves fast!)? If an author isn't citing well-known, high-quality research (or any research at all), that is a major red flag.
A — Author
Who is behind the claim? An SLP? A doctor? Some guy in his basement wearing a freshly pressed button-down and shabby sweat pants? Sometimes, the savvy salesman giving us a message makes us forget to focus on the message itself.
B — Buzzwords
Beware of "miracle cures," or "secret hacks." Science isn’t dramatic. It’s slow, tedious, and to be frank… a slog. Scientific and medical progress isn’t a superhuman figure crushing through brick walls. It’s more like a hundred thousand clinicians and researchers pushing against a boulder the size of Manhattan. If we move an inch every week we are booking it. But that’s how science works. That’s how medicine works. The buzz words I’m looking for are “research-based, “randomized controlled trial,” and “systematic reviews.” Sexy? No? But it’s that kind of work that cured polio, transplanted a lung, and reduced the risk of deaths from heart disease by 90% over the last few decades. These kinds of accomplishments never have and never will come from a miracle or a hack. They come from really smart, dedicated people who do really hard work. So the next time you see a post using high-emotion language or promising a quick fix for a chronic, complex issue like dysphagia, remember this is marketing, not medicine.
S — Scope of Practice
Even if someone is a real doctor, are they staying in their lane? A world-class neurosurgeon might not be the most reliable source for the latest nuances in esophageal manometry. Credible creators respect the boundaries of their specialty. I recall recently seeing a physical therapist making lots of unfounded claims about a high-profile individual who may or may not have dementia. Not to say that PTs don’t have a tremendous amount of value to add to healthcare discussions, but if I’m seeking an accurate dementia diagnosis, physical therapy is not going to be my first stop. Give credit only to those with the credentials to back up their messages.
Conclusion
I like this framework so much because it’s a simple, straightforward reminder that we can and should be critical about everything that comes our way. Including the research literature itself. We don’t feed our children everything that’s advertised at the front of the aisle in the supermarket, no matter how shiny or sweet it is. By using the right tools to filter out the noise and the distractions, you ensure that the clinical decisions you make are based on evidence, not an algorithm. Next time you're online, remember: don't let a flashy post pinch your patient’s health. Because that’s the only thing worth protecting.
Reference
Stokes-Parish, J., Habibi, R., & Toomey, S. (2022). Navigating the credibility of web-based information during the COVID-19 pandemic: Using mnemonics to empower the public to spot red flags in health information on the internet. Journal of Medical Internet Research, 24(6), e38269. https://doi.org/10.2196/38269
