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Marta Pucci


“Alternative” approaches to health: How we think about health information at Clue

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We sometimes get emails asking why we collaborate with naturopaths for our online content. It’s a fair question — evidence-based medicine is at the center of all we do at Clue. Here’s a quick look into how we think about delivering health information at Clue.

First-stop resources

When deciding how to incorporate a new topic into Clue, we look for the highest available quality of up to date research, the current scientific consensus’ when possible, and existing clinical gold standards (methods or procedures recognized as the best available). These are our first stops when writing informational content on health topics, or when doing background research for new features.

We work directly with some of the world’s top clinical researchers on menstrual health via our med board and research partners. We use services like Uptodate, which incorporate new peer reviewed research (when sufficient) into current clinical gold standards of practice. We do internal literary reviews, of varying depths, when appropriate.

At the same time, many elements in the fields of reproductive and menstrual health remain vastly under-researched. This is something that we are working to change at Clue, with our research collaborations. But as it stands, people can be left without answers to important health questions, and without sufficient treatment or management plans. It takes a lot of time for emerging research to reach and be integrated into the mainstream.

In many cases, sufficient treatments just don’t exist yet, or focus on symptom-management, even for very common conditions like endometriosis, or polycystic ovarian syndrome (PCOS). In the US, it’s estimated that PCOS affects between 6-12% of women, making it the most common cause of female infertility. But researchers still don’t know exactly what is it, what causes it, or how to treat it (everything about PCOS is being debated, including its name). The typical management plan is long-term hormonal contraceptives. This works for a lot of people, but others are turning to the internet to read theories on what might be causing their health condition, or to explore other options for management. Finding the best of that information, or sorting through the evidence (or lack thereof) behind other treatment options is difficult.

Second-stop resources

Which brings us to our second-stop resources (not secondary sources, just number two on our list). We look out for newer research (and the researchers conducting them) to see what recent contributions are being made to burgeoning bodies of knowledge. Sometimes this is all of what’s out there.

We aim to make it clear if we ever share any findings which are controversial, unreplicated, or when further research is needed. It’s surprising how much fits into this category.

Many menstrual health-related researchers go into their fields thinking they’ll research a specific topic, to then learn how much fundamental research is still lacking, and then have to back up to start with basics.

This happened to a Columbia University collaborator of ours, Noemie Elhadad, when she started her machine learning research into endometriosis: it’s still not known what causes endometriosis, exactly, and the diagnostic tools aren’t well-defined.

As mentioned before, we also offer a platform to a few naturopathic practitioners as a complementary voice. Any naturopathic collaborator who has produced content for Clue has completed their education in a place where naturopathy titles are highly regulated, such as in many provinces within Canada and some states within the United States. In these places, the “naturopath” title is achieved with graduation from a four year post-graduate program leading to status as a primary caregiver. This is in contrast to “naturopath” as a catchall phrase of herbalists or homeopaths, who might be self-trained or trained outside of a regulated body.

That is not to say Clue aligns itself with everything taught in regulated naturopathic programs. Pieces authored by all our experts go through the same thorough internal editing and reference-checking process. We are upfront about the differences between this advice and gold-standard clinical advice, and we don’t publish any medical information that is overly anecdotal. In certain cases, a practitioner’s individual opinion might be shared, but we disclose it as such, and are selective in what we present in this way.

When searching for options and opinions to underreseached menstrual health issues, it’s unapproachably difficult to distinguish the level of rigor behind an opinion or any advice that is outside of clinical norms. We’re working to bridge that gap.

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