6 ms·
I'm a doctor, but I'm not here to take sides on the Q-tip issue. I'm here to clarify how many (but not all) of us use medical research: the "pyramid of evidenc
by phren0logy 6y ago
I'm a doctor, but I'm not here to take sides on the Q-tip issue.
I'm here to clarify how many (but not all) of us use medical research: the "pyramid of evidence."
The idea is that I rely upon the best available evidence, which (roughly in order) is: meta-analysis, randomized controlled trials and other prospective data, retrospective analyses, expert consensus, and (finally) clinical experience.
This is rough because there are good critiques of meta-analyses as a tool, the available data may be a bad fit for that patient, research biases, etc. A big one is that many questions don't have a big commercial upside, so nobody will ever fund a good prospective blinded trial. Which takes us to the last point: absence of evidence is not evidence of absence. Just because all the of the studies about Q-Tips are low quality doesn't mean a better study would find something different. We don't know the answer to that, and that would be a big assumption to make.
So, sometimes the best available evidence is not statistically ironclad. It falls on us to use a reasonable approach about how hard a line to take. Some do a better job than others.
That was long and rambling, but hopefully it helps to clarify some misconceptions. As an applied science, we have to go with the data we've got, which is almost always not an ideal fit for the patient in front of us.
- JMTQp8lwXL 6y agoRegarding the commercial upside: Wouldn't q-tip manufactures have an incentive to prove using q-tips is, in some way, beneficial? In the case there is no benefit, but it's unclear if they are harmful, for what purpose do they serve? At least with respect to human anatomy. Q-tips have other applications, like cleaning electronics, but I am considering those uses not germane here.
- handol 6y ago> for what purpose do they serve? It feels good to scoop the goop out of your ears after a hot shower.
- dcolkitt 6y agoI'm someone who naturally produces a lot of ear wax. I don't think people really appreciate just how unpleasant it is. After it builds up past a certain point, sounds become distorted and it's hard to decode individual words. It can often be extremely itching and irritating.
- pugworthy 6y agoI think those of us with hearing loss can appreciate the unpleasantness pretty well.
- skj 6y agoUse an ear syringe. So much more effective and, to my knowledge, no one has raised serious safety concerns.
- johnisgood 6y agoExactly this. Use a syringe and inject hot (but not too hot) water into your ear with your head tilted. Do this a couple of times. Then you should use a paper tissue and your finger to get it out what you can. Repeat. I dunno if this is a good advice, but it worked every time I got excessive build-up. Some people just tilt their head to the right side in case it is their right ear and aim the shower head at their ear for some time. Sometimes it can just "fall out" (really, seen it happen!). Regardless, I just do the syringe one and paper tissue + finger.
- DigitallyFidget 6y agoI absolutely agree to that. However, the boxes of all brands I've seen state to not use inside the ear. I skull-fuck myself almost daily (unless I run out) and my doctor merely praises me for having such clean ears. Even if I go weeks without using a Q-Tip in the ear, they still come out only barely dirty. I mostly just do it because it feels great. I can understand how if you have thick wax buildup it could be packing the wax deeper in, but for me that's not the case. When I insert the Q-Tip, I feel the cotton making direct contact with skin the whole way in.
- httpsterio 6y agoI'm the same as you, but the past two three years, my ears dry from using a q-tip. I literally start to have cracked dry skin and bleeding in my ear canal from excessive q-tip usage and these days I can't even use them weekly without issues.
- lotsofpulp 6y agoI have never felt the need to scoop anything out of my ears. And I don't see anything visible from the outside of the ear that would need scooping. I assume any wax further in the ear probably belongs there as defensive barrier.
- skj 6y agoPhysiology varies quite a bit.
- asdff 6y agoI never do either, until I grab a pair of in ear headphones and recoil in horror at the globs of ear wax that they yank out. I have actually killed apple earbuds like that from clogging up the mesh barriers with wax. Regular maintenance keeps that from happening.
- Throwaway1771 6y agoYou need rubbing alcohol - any Jesus ;D
- e40 6y agoEspecially for users of in-ear speakers. Nasty as heck using them with dirty ears.
- phren0logy 6y agoDoing a good research study would be expensive. At the end, people would either: see a good outcome, and keep doing what they're doing (sticking Q-tips in their ears), or a bad outcome, and buy fewer Q-tips. So, probably not much of an incentive.
- JMTQp8lwXL 6y agoI think this understates how many people could be avoiding q-tips because they're potentially bad. A good outcome of a study could have a material impact on sales.
- bigbubba 6y agoI honestly doubt it. The unpleasant sensation of having my ears filled with goop is far stronger than any caution advised on the package. And those who don't experience this don't have a reason to use them, even if they are advertised as safe.
- alextheparrot 6y agoPeople still buy them for cleaning their ears, so at least a subset of their sales are not research dependent. One cynical hypothesis would be that they tried to prove they were beneficial, failed, and that’s why we have an absence of research to that point. It also could be just as the original poster mentioned, maybe no one has really felt like the investment to ask the question would be worth it.
- Scoundreller 6y agoThere’s also publication bias. Maybe they’ve done the research and decided against making it public because it wasn’t what they wanted to see. Just sell off the product line, destroy all that research/shuffle the researchers around, and the acquirer is none-the-wiser. But they were sure to erase any anatomical hole depictions on the packaging.
- deleted 6y ago[deleted]
- csharptwdec19 6y agoI always operated under the assumption that it was just safer for them from a liability standpoint. Between the risk of somebody unable to properly handle the physical feedback loop and/or respect for their anatomy required to safely clean one's ears, the risk of a strand of cotton getting stuck in some wax and somehow turning into a weird infection... just a lot to go wrong.