CONTRA-INDICATIONS EXAMINE HEALTH CLAIMS CAREFULLY, ESPECIALLY IF THEY SOUND TOO GOOD TO BE TRUE.

Byline: Evan Henerson Staff Writer

A GLASS of red wine is absolutely the best and most pleasing way to stave off the possibility of heart disease.

Unless ... you're worried about becoming an alcoholic or increasing your risk for breast cancer, warns the American Heart Association.

Well, at least we can all agree that every woman should be getting a mammogram once a year after age 40. Or is it 50? What's that? You say Danish scientists maintain that 30 years of mammography data are so flawed that the screening's life-saving potential is now under scrutiny?

Who to believe? How to proceed? Between technical medical journals, reports in the daily paper, a three-minute television news segment and the informational grab bag known as the Internet, a health-conscious individual can quickly reach data overload.

So what do you do when two equally reliable sources - each claiming to be armed with well-researched, hard statistics - deliver opposite messages? And how about those studies of new or alternative methods promising that the key to weight loss, hair regrowth or cancer eradication is just a full-body scan or a daily tablet away? It might sound like tabloid medicine, but there will always be somebody who claims it works.

Flushing money away

``Whenever I hear about colonic irrigation, it makes me laugh,'' says Dr. Samuel Fink an internist who chairs the institutional review board at Tarzana Regional Medical Center. ``I have one patient who swears by it, but there's no indication that it's helpful.''

Doctors and researchers consulted for this story agreed that medical research should be considered a ``work in progress'' and that anybody claiming to possess a guaranteed silver-bullet treatment might simultaneously be earning a paycheck in the snake-oil trade. If something seems to good to be true or too weird to be believable, it probably is - on April 1 or any other day.

``It really is the consumer kind of left stuck in the middle,'' says Dr. Lawrence D. Wagman, chairman of the division of surgery at City of Hope Cancer Center. ``When you're talking about mammography and screening, the person is not a patient yet, but someone who is trying to prevent a disease. Often, the patient is facing decision-making based on what they hear coming over the airwaves.''

Do the homework

So get as much information on your own as you can, doctors advise, but never start a new course of treatment without first consulting your physician.

In fact, say the people who keep up to date on medical studies, your doctor is usually the person who can offer some perspective on the study or report you bring in to his office. If he doesn't know anything about it, he should do some research and get back to you. If you have friends who are in the medical profession, even if they're not treating you, ask their advice as well. A second, third and fourth opinion never hurts.

And don't be afraid to do a little detective work on your own. We asked doctors and clinicians, people who conduct their own research studies or make a habit of devouring other people's for some data navigating tips. We even pulled some sound advice from the Internet, which, as everyone knows, is never wrong.

Consider the source: Figure out who's put up the bucks to produce the data. Is it someone with a proven history in the realm of medical studies - a Johns Hopkins University, UCLA or the Mayo Clinic - or is the data coming from a person or institution you don't recognize?

For that matter, where is this information being reported and distributed: in the health section of a major newspaper or newsmagazine or on the same supermarket rack alongside headlines like ``Halle Berry is Reincarnation of Elvis!''?

``Most people would know which are the reputable hospitals and medical schools,'' says Dr. Alan Robinson, vice provost of medical sciences at UCLA School of Medicine. ``If they're searching a Web site and find the information on the medical school's Web site, that's usually been edited, and some medical expert has looked at it.''

Want a second opinion? Try a national umbrella medical organization like the National Institutes of Health, the American Heart Association or the American Cancer Society. If the organization is addressing the study - pro or con - that usually lends it a kind of legitimacy.

Spin control: Read the entire article or study. If the study's conclusions are being reported in a newspaper, make sure the account seems balanced and includes an expert who takes issue with the study. Be wary if the study appears to have been conducted with an aim toward getting the consumer to pull out a checkbook and buy a product.

``As government funding dries up, a lot of studies are being done by drug companies,'' says Fink. ``Do they have a conflict of interest? Can they suppress negative results? You're never going to see a study that says a drug kills people. The only things we'll hear about are things that lower our cholesterol, lower our blood pressure and help us have better sex.''

Or lose weight. The Web page of controversial weight-loss specialist Dr. Robert Atkins positively gloats over being able to report ``Clinical Trial Validates the Atkins Thesis.'' The article gleefully reports the findings of two studies - the first conducted at the Durham Veterans Affairs Medical Center, the second within the Atkins Center itself.

And if there's a brand-name product at the center of the study, watch out for what we'll call - for lack of a medical term - the ``duh!'' factor.

``The common ones are the weight-loss claims that say, 'If you just take this pill and don't eat, you'll lose weight,' '' says Robinson. ``Big surprise. There's often something coupled there that makes the statement true even though it doesn't depend on the product.''

Give me details!: Conclusions are all well and good. But check out how the researchers reached them. How many people participated in the study? Where did the study take place and under what circumstances?

Are the goals of the study clearly stated? How about post-study follow-up to determine how the patients fared after the study reached its conclusion?

In mid-March, the Mayo Clinic reported encouraging evidence that a daily dose of aspirin, ibuprofen or other nonsteroidal anti-inflammatory drugs might help prevent prostate cancer. The findings came after 1,362 men were tracked over 5 1/2 years. In the study, 569 men took an NSAID daily, while 793 did not.

The study's headline: ``Could an Aspirin a Day Help Keep Prostate Cancer Away? Possibly.'' The study's lead researcher, Mayo Clinic epidemiologist Dr. Rosebud Roberts, is quoted as saying the data looks promising, but that more research is needed. ``Our findings ... are not conclusive,'' she says.

Inconclusive findings. Not exactly the news a health seeker is looking to find, but until medicine becomes an exact science, in many cases, it's the best we're going to do.

Upon further examination

Which medical choice do you make when there are two schools of thought?

So many conclusions, so many opinions. Can't we all agree?

Red wine

Pro: In July 2000, researchers from the University of North Carolina at Chapel Hill report ``very exciting findings'' about the presence of trans-Resveratrol, or Res, a potential anti-cancer and anti-inflammatory ingredient found in red wine. The finding lends further credibility to the so-called ``French Paradox'' theory. The French eat more artery-clogging foods but have a lower incidence of heart disease.

Con: In January 2001, the American Heart Association urges its physicians to tell patients that there are ``other risk-reduction options that are well-documented and free of the potential hazards associated with alcohol consumption.'' Those hazards may include alcoholism, liver disease and an increased risk for breast cancer.

Mammogram

Pro: In March, researchers from Umea University in Sweden published findings in Lancet concluding that mammograms reduce a woman's risk of dying of cancer by 21 percent in the long term. Dr. Peter Greenwald, cancer prevention chief at the U.S. National Cancer Institute, said the NCI had reviewed the evidence and reached similar conclusions.

Con: In October 2001, a team of Danish researchers led by Dr. Peter Gotzsche, director of the Nordic Cochrane Center, concluded that landmark mammography studies conducted in the 1970s and 1980s were so flawed, it was impossible to gauge whether they had, in fact, saved lives.

Full-body scans

Pro: Clinics across the country are offering head-to-toe computer tomography scans. Many doctors say the scans can help people without symptoms detect signs of heart or lung disease.

Con: In July 2000, the American College of Cardiologists and the American Heart Association said that while a calcium scan can help indicate coronary artery disease, the test should not be used for widespread screening until additional research can demonstrate that such a test can prevent deaths more effectively than cholesterol monitoring and lifestyle changes.

Garlic

Pro: Dr. Stephen Warshafsky, associate professor of medicine at New York Medical College in Valhalla, conducted one of the first major studies to suggest that one clove of garlic per day could lower cholesterol by up to 9 percent.

Con: In October 2000, a new evidence report by the Agency for Healthcare Research and Quality - requested by the National Center for Complementary and Alternative Medicine - concluded garlic may lower some types of cholesterol in the short term. However, the use of garlic does not appear to offer long-term protection against cardiovascular disease.

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(cover -- color) WHAT TO BELIEVE?

Take conflicting medical studies with a healthy dose of skepticism

Jon Gerung/Staff Artist

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Upon further examination (see text)