Transcript: Peer Review and Tylenol
Lily: Ok. Are you ready?
Sarah: Yes, let’s do it.
Lily: Hello and welcome to our research discussion for UTMone Scholars
Sarah: Aka us sitting in this podcast studio for two hours until we run out of things to say.
Lily: This seminar course is centred around the topic of misinformation in the information age, diving deeper into how scientific issues are communicated and how that can be prevented.
Sarah: My name is Sarah, and I’m a first year student at the University of Toronto Mississauga working towards a major in sociology.
Lily: My name is Lily, and I’m a first year student at the University of Toronto Mississauga in the forensic science program.
Sarah: The main purpose of this discussion here today is to review our research, discuss how we arrived at our conclusions, and think about the big picture: how does our research enhance our understanding of scientific miscommunication, and what have we learned from this process?
[Intro Elevator Music]
Sarah: Ok so we are starting our conversation here today with Lily’s paper. Lily, can you give a brief summary of your research?
Lily: Yeah. So my research paper is all about the peer review process, and it focuses on how it can be manipulated and the steps we can take to improve it. For anyone unfamiliar, peer review is a vital process in the scientific community used to fact check or give credibility to research. It functions typically by a researcher submitting their work to a journal run by an editor, who looks over the paper and decides if they want to publish it. Before publication the editor will set up a group of peer reviewers - who are usually people in the field doing similar work - to look over the research and ensure it is of good quality and is overall correct. After a few rounds of edits, the paper would be accepted and then published in a journal. This process is integral to all knowledge building as it provides a foundation truth that other ideas can be built off of. In this process, the editors and the reviewers themselves hold a lot of power and there are certain ways they can manipulate the system which leads to the spread of misinformation. My study explores these areas where problems may be occurring in order to come up with solutions that could help reduce the amount of misinformation that gets spread due to the system failing.
Sarah: Amazing. Why did you choose your research question?
Lily: Yeah so I am personally very interested in the scientific community as well as research as I am currently doing my bachelors of science, and in that community peer review is extremely important. Before starting this class, I was aware of peer review as a standard but I didn’t know the specifics of how it worked. In the early weeks of class we learnt a bit about how it works and how the system is set up and it immediately sent up some red flags for me. Peer review is viewed as this gold standard in the industry so I was really shocked to see so many inconsistencies in the way its run between journals and the amount of areas that could be exposed to exploitation. It was when I found my first case study that I decided on my research question since that's when it was first revealed to me just how easy it is for articles to become peer reviewed as long as you have the right connections. Overall I really think the system does need to be improved and if we are going to keep treating it with such a high level of importance, we really need to find new solutions. So I was curious to find the suggestions myself on how we could possibly change it.
Sarah: Yeah and I think also when we’re doing assignments there's always that little criteria where we have to have peer reviewed articles so it’s a huge deal. I come across it and I’m in social science and humanities and obviously I feel like it’s something that you’re going to come across your whole entire university career as well as me.
Sarah: So, as I read your knowledge building section, I thought a lot about the consequences that can come from improperly validified articles. And this is something you mention as well. What responsibilities do scientists have to make sure the information that they are citing is valid? And do you think your paper shows that faith in the peer-review process is enough or that it isn't?
Lily: Yeah so I think my biggest takeaway that I had after writing my paper is that an article being peer reviewed is simply not enough. Right now I’m in multiple different science-based courses and have had to do numerous academic assignments that require me to use only peer reviewed sources like you’ve mentioned, as if that's the only thing that makes them credible. I think a lot of people who are uninformed about the process don’t know all the ways it can be manipulated so the problems end up getting ignored. Through my case studies specifically it was seen that there are articles right now with blatant false information in them that are still considered peer reviewed. I think scientists have an extremely high responsibility to make sure they are only using credible sources, especially if they are building knowledge off of those ideas, because if the sources are not credible, then they are contributing to misinformation themselves. There needs to be more analysis that comes into play when choosing sources for research and an article being peer reviewed is simply not enough.
Sarah: Yes and your paper was this huge lightbulb moment for me because it is really something that I never considered before. And you discuss how the peer-review later can be manipulated by the editors and reviewers and you mention - and ok I’m going to quote you directly here - that “Certain journals will employ an expert in the field who has previous publications, while others believe more strongly in eliminating personal interest by employing editors not actively connected to the subject”. So, how do you think journals should decide for or against employing reviewers who know the topic?
Lily: Yes. So this quote in my paper was referring to the editors of journals. Nature themselves, which is one of the biggest scientific journals, has come out and has stated that they do not believe in employing editors actively connected to the field. In my opinion this does make sense as it would help eliminate editor bias, as if someone is actively connected to that field they might use their power in order to publish their own research, their friends' research or research that helps their own. But at the same time I think it's a tricky balance as if you employ someone too far connected from a field they might not have enough knowledge to know what research is the most important. When it comes to reviewers, there’s a similar tricky balance that comes in because editors will sometimes pick people in the same general field as the research being submitted or in the same specific niche. This has the same kind of tricky balancing problem where if the field is too broad the reviewer might not have enough knowledge to do a good job at reviewing it but if the field is extremely niche there could be bias involved, especially if the reviewers are familiar with the work of the researcher or might have personal connections.
Sarah: Right. Ok so your study addresses that there are dwindling options for peer reviewers like you mentioned. Therefore, do you think that journals should broaden who they select as peer reviewers, or should they keep pushing for niche groups of people even if there aren’t many to choose from?
Lily: Yeah so. As I mentioned previously, there are a lot of pros and cons for reviewers being involved in a specific niche versus the general field. I think in a best case scenario the review board would be made up of an even mix of both in order to eliminate the bias that can come from either side. Overall though journals have been really struggling lately to find any reviewers at all since the pandemic. I mention as a potential solution in my paper that all journals should switch to a fully open review system that would add the names of the reviewers to the published articles themselves. This hopefully would act as a way to improve the peer review process by holding everyone accountable, but also could create a form of incentive for reviewers. Having their name on published work, not necessarily as an author but still, would help contribute to their credibility as a researcher and hopefully provide them with more opportunities in the future. With this incentive would hopefully come more reviewers in order to help with the dwindling numbers editors are facing and really improve this issue.
Sarah: Yes and I think if your name is out there like you said, it’s that incentive to, because if you’re anonymous you might pressure yourself to just slip through the cracks -
Lily: Yeah
Sarah: - So I think if your name is out there it just holds you accountable, it lets people know this is what I did, this is where I am and I think really it’s just better and I’m surprised that they don’t do that.
Lily: Yeah and also publications are a huge part of the scientific community and process like if you’re applying to a job you usually submit your publications as a form of credibility and an example of the research you’re doing so if you could attach your name as a reviewer, kind of as like a subcategory, it kind of gives you more credibility so people know who you are already and gives you a better chance of future job opportunities or grants
Sarah: It really just shows what you’re participated on, and yeah I think that’s really really important.
Sarah: Alright so you stress that in theory financially compensating peer reviewers for their work is a good idea but that it’s not realistic. Do you think compensation would contribute to the issue of peer review misinformation?
Lily: Yeah so this is actually a suggestion that came up a lot, so when I was analysing the suggestions other researchers had proposed to fix the peer review system financial compensation was one of the main solutions given to help the reviewer shortage issue. While this does seem like a good idea in theory I don’t think it’s realistic for many journals. A lot of research in science is already underfunded and most journals would not be willing to give out money for something that’s already free. Also as you mentioned it does give an ulterior motive to the people doing those reviews who may not be qualified or may not do as good of a job just to make some extra money.
Sarah: Yes, and you mention the areas where the system can be exploited quite a bit…what are these problems you’re talking about and how much impact really can they have?
Lily: Yeah so during my study I used two main case studies where misinformation made it through peer review in order to really discover what areas of the system had failed and the main issues peer review faces so I could propose some viable solutions. One of the first issues I found was the motivation for lesser known journals to publish more research. If you think about it it kind of makes sense. A lesser known journal is going to receive fewer submissions which means there’s less competition and fewer articles to choose from. This gives them more motivation to publish each submission that they receive because obviously the journal still has to put out an issue every month. That means that if you are smart enough to publish your misinformation to a lesser known journal it has a pretty high likelihood of making it through peer review solely due to the motivation that they don’t have anything else to publish. So this does create some barriers because obviously it’s harder to get your work published in journals like Nature that are really highly known but whether we like it or not smaller journals do have less credibility just because a lot of the time they have some really sketchy peer review systems and way less submissions so the works that are getting published there are less accredited, this does really suck, but i think if they would be more open and honest about their peer review systems and making sure that the things that they’re publishing are actually credible it would make them more reliable.
Lily: Another issue I saw was the impact of repeat reviewers, this is a problem that has really come to light due to the shortage of reviewers and has had a lot of implications with bias. So because there are so few reviewers willing to review studies right now, editors keep using a lot of people to review multiple studies multiple times. This has a big problem actually to do with collusion. I actually saw in one of my case studies where a bunch of these articles had been published. They were all being reviewed by the same group of people. It was almost as if these editors knew they were misinformation and has put together a group of like-minded people to just get them to review and publish them anyway. So there really is a lot of stuff that can go on behind the scenes that people don’t know about to exploit the system. If you have the right connections and you know the right people who are willing to do that for you.
Lily: But the biggest problem that I saw highlighted in both of my case studies was the impact of editor bias. The power that editors of journals hold is widely underestimated. Editors pretty much make all the decisions when it comes to what is published in a journal. They pick which articles undergo peer review, they even pick what journals get published after peer review. They hold all of the power in this situation. This means that if an editor has an ulterior motive to publish something like someone’s paying them or they want to publish their own research, they can do it because they’re the ones who have the sole decision to publish things. So I really think that there does need to be more delegation when it comes to the decisions being made at research journals in order to eliminate this kind of biases.
Sarah: And one thing I really really loved about your paper is that you never seem to trash peer review, and you did acknowledge it as something that is very very valuable, but that it just needs to be reworked and I think that your next steps and your proposed solutions is just, it’s my favourite part of the paper because it’s so valuable and it’s something that needs to be addressed, something that needs to be thought about, like a lot of issues there are ways that this can be reworked that are very very realistic.
Lily: Yes thank you, I was trying really hard while writing this paper to make sure that I was never saying that peer review was bad and that it shouldn’t exist. Peer review is like I had mentioned multiple times before, it is an integral part of the process to validify and accreditate sources. We need it, it’s super important. There just are certain areas where things can fall through the cracks leading to misinformation. I think there are some pretty simple, viable solutions that can be used in order to fix up the system and make it a lot better. I think a lot of people find it really easy to trash peer review, they like to judge it a lot but there are very very few realistic solutions out there that will actually improve what’s going on without just tearing it all down, because we do actually need it here in place.
Sarah: It’s great that the foundation is there, it just needs to be rebuilt.
Sarah: Your research shows that peer-review misinformation is prominent and needs to be addressed. So what are some of the attainable solutions/next steps that can be taken?
Lily: Yes, so in my paper I talk about two main solutions that I have come up with. The first is related to the fact that right now there are so many different forms of peer review in place. There’s double blind, triple blind, completely opened, completely closed and every paper does it differently, there’s a huge lack of consistency in the system. When analysing the existing literature, I found that the only system that was proven to actually reduce the spread of misinformation was the open review model. With this model, the identities of everyone involved in the review process would be published along with the article, to be accessed by the public. This would act as a way to make sure that accountability can be assigned if misinformation is being spread as it can be checked by other people in the community. This would also hopefully improve the quality of reviews as it would be known exactly who performed the review itself. As I mentioned before there would be the element of incentive for the reviewers that would help improve those issues as well. The most difficult part about this solution is that all the journals would have to make the switch. I think the best way for this to happen is if Nature was to make the change themselves. There were the ones who initially popularised peer review in the first place and they are one of the most influential journals, so if we could get nature to make that change I think a lot of other journals would follow suit.
Sarah: It’s almost like if they were starting a trend.
Lily: Yeah pretty much [laughs].
Lily: The other solution that I proposed was inspired by my second case study. Because I have established that I do not think peer review is enough to give an article full credibility, I think a new assessment form needs to be created. I think the creation of a governing body or an organisation prioritised with assigning credibility to the individual peer review systems of different journals could provide an excellent resource for researchers. This organisation would be responsible for giving each scientific journal a score for their peer review process based on several factors. One, would be how easy it is for misinformation to make it through their system, measured by the organisation intentionally sending out hoax articles to different journals on a regular basis to test if they become published. They would take this information in combination with how open each journal is about their system, aka have they switched to the open review model, and give them a score. I’m not sure about other people's experience but here at UofT, when an assignment asks you to provide a certain number of peer reviewed articles, we’re told to check on a site called Ulrichsweb to check if that journal is peer reviewed. This organisation would function in a very similar fashion, where you could look up the name of the journal where the article is from and check their individual peer review score. Professors could then even ask in assignments for students to provide sources from journals only with a score over a certain number. This idea would replace the simple accreditation of peer review as the gold standard and provide more criteria about the quality of sources.
Sarah: And it goes beyond just checking that little “peer reviewed” box, after you make a search -
Lily: Yeah
Sarah: - so I think that’s really really helpful and I’ve never heard any kind of proposed perspective on that, ever.
Sarah: So, what have you yourself - and I think this is a really important topic to touch on - learned from writing this paper? How can you use the information that you gathered in certain aspects of your life moving forward?
Lily: Yeah, so I learnt so much about the credibility of knowledge while writing this paper. The biggest thing I took away from it was that an article claimed to be peer reviewed does not necessarily make it accurate or of the highest quality. There still needs to be some critical thinking involved with the selection of sources, and more people need to be aware of that. I also realised how important it is in research for scientists to only be using credible works if they are going to build off of those ideas. The only way new discoveries can be made is based off previous work, and if that previous knowledge is actually incorrect, it can create this spiral of misinformation that is really hard to get out of. Overall, in the future I really hope to see some further education about the peer review process especially for younger scientists to encourage that critical evaluation, and maybe even some changes implemented by journals to help improve the system.
Sarah: Amazing.
[Transition]
Lily: Ok so we’re gonna move on to Sarah’s research paper. Can you give a brief summary of your research paper?
Sarah: Yes, so my research paper focuses on acetaminophen, which is an ingredient included in a lot of over the counter medications - or OTCs - that treat minor aches/pains, fever, and just a variety of different yet common issues that we ourselves experience or see others experience on a day-to-day basis. I mean, if you’ve ever taken medication for a headache, I can almost guarantee you that you were taking acetaminophen.
Sarah: And specifically, I zero-in on Tylenol, because it’s one of the highest distributed medications globally, and more importantly it’s a brand name people recognize. The problem, though, is that with these medications there are a lot of people who will just assume that because you can see them on shelves - that red label - that they don’t pose the same risks as medications protected by pharmacists - prescription drugs. According to the trends in the ER visits in the last decade, we see about 500 people per year die from what we call acetaminophen-induced hepatotoxicity, which means that they have ingested too much for their system - more specifically their liver - to handle.
The statistic that is shocking however, is that 4500 people are hospitalised because of acetaminophen overdoses every year, but about 50% of those cases are accidental. 50% of people are taking more than the limit, and that’s a very significant number.
Sarah: So, to answer your question, my paper basically just asks why. Why is this happening to so many people? Through case studies, I look at who this has happened to, and why, and then I look at the policies. So how have these cases shaped how Tylenol is regulated?
Lily: Yeah. I think this is a super important issue that a lot of people don’t know about. Why did you choose your topic and your research question?
Sarah: So I chose my topic because of a documentary on tobacco, weirdly enough. It was called Merchants of Doubt, and it looked into how tobacco was basically manipulated so people would just think “hey this is good, nothing to see here” but in reality it kind of created this domino effect that I won’t get into.
But it got me thinking about acetaminophen, antihistamines, ibuprofen etc. and how I feel like there’s a similar narrative going on here. These medications are everywhere and I had always kind of had always just known? that they were dangerous but I never really went further than that knowledge.
Lily: Yeah so my mom works for Health Canada so when I first started taking Tylenol or Advil pretty frequently she made it very very important that I read the label and know exactly what I’m taking so when I was reading your research study I found it so surprising that so many people were taking way over the limit without even knowing. To me it’s just normal to understand how that medication works but I can understand that if you never received that education it’s really hard to understand how these drugs should be used and misuse of them can be really dangerous.
Sarah: Yes, and I have a similar story, so I get headaches a lot, and that’s really really common for me unfortunately, so I do take Tylenol sometimes daily and so does my mom - and she’s also in healthcare, and I have been told in the past that I have what they call medication induced headaches, which is basically the closest you can get to a Tylenol addiction without actually having one, because medically it is impossible. And that knowledge really got me thinking and as I was writing this paper. I don’t read the label. I know, because my mom’s told me and I guess in a similar situation your mom told you, but what about the people who don’t know? And how many people aren’t reading the label if that statistic is 50%?
Lily: Yeah it’s really crazy to think about. So your study hinges on these five extremely devastating case studies. How did you find them?
Sarah: Finding case studies was the hardest part of my research because for one, these cases are really really personal, and then I had to make sure that what I was looking at was a case that was an accidental overdose versus an intentional overdose, and another thing was these cases needed to be detailed enough because it was really important that I had the numbers, I needed to know how much was taken, what the outcome was. And that was hard because a lot of the studies I found just wouldn’t give that information. They would just say like “this person, age this, died from an acetaminophen overdose” and that was it.
Sarah: And yeah so the way I found these studies was kind of all over the place. I found one through the Toronto Star along with a very detailed and devastating blog written by the parents of a girl who overdosed. And another one I found through an article in the journal of critical care medicine. And then I also talk about the Chicago Tylenol murders which started with a podcast by the Chicago Tribune called Unsealed, and the legal cases I found after that were just via news articles. So I don’t really have one answer to that question, it’s really all over the place.
Lily: Yeah so these case studies were so surprising to me and I think it’s crazy that I actually hadn’t heard about any of them, you’d think that something like this would get a lot more media coverage.
Sarah: Neither have I.
Lily: Yeah, so which of these cases did you find the most surprising or telling about the issues?
Sarah: Honestly, the numbers. So, take one of the cases I found about a woman - she was 27 years old - in Ohio, and she took 8,000 mg of Tylenol per day.
Lily: That’s insane.
Sarah: Depending on the product, like I really wanted to just put that, or make that make sense in my mind. That is 16-24 capsules of Tylenol, and she took it accidentally. To prevent herself from getting Covid. And there are just so many cases like hers. There are so many.
Sarah: And then another case that I was shocked by was Ashley Campbell, who overdosed on Tylenol but she also had alcohol and cocaine in her system. And she said she took about 4-5 capsules (which really isn’t extreme if we compare them to some of the other cases), but she would have taken them all at once. And what really shocked me about her case is that she didn’t survive, which really shows how having other chemicals in your system can impact how your liver handles an overdose.
Lily: Yeah I feel like there’s a lot of emphasis on making sure you take the correct dosage of a drug but a lot of people don’t know that you actually should not be on alcohol at all while taking Tylenol. That’s crazy.
Lily: A major theme throughout your case studies is improper use of the drugs based typically on disinformation. How much of the blame do you think falls on Tylenol as a company versus the individuals themselves who might have taken it incorrectly?
Sarah: I think it fell on Johnson & Johnson first, because twenty years ago the only thing these bottles said regarding this was that “it’s hazardous to exceed the maximum recommended dose unless advised by a physician”. I don’t think that’s enough. The Acetaminophen Labelling Act was a huge deal because it mandated that we mention the symptoms of liver failure, that you can’t take it with alcohol, how much you can safely take in 24 hours (and that’s 4000 mg), that it’ll affect children differently, etc. And that information is so important because if you’re reading the label, those are going to be the questions ultimately that you are going to want answered.
Sarah: But the thing is though, these numbers - the people who are dying and being hospitalised - they aren’t getting better. And that’s where those alarm bells start to go off for me because that means people aren’t “always reading the label”. And I was one of them. I was part of the problem. And my goal here, I want to make it really clear, wasn't to go after Tylenol or convince people that you shouldn’t use it because that’s really not the case. It’s popular for a good reason, but along with that good, there are problems.
Lily: In response to one of your case studies Health Canada finally updated the labelling standards for acetaminophen. Do you believe all OTC drugs should have strict labelling guidelines in place and how much of an impact does the labelling have on safety?
Sarah: Labelling does not have the impact on safety we need, but it does - one really great thing about it - is that it allows anyone who uses it to stop and think. And that’s really crucial if they choose to do so. So yeah, my simple answer is that I think labelling guidelines do need to be there.
Lily: Throughout your study we’ve seen acetaminophen cause unintentional overdoses and liver damage. What are the next steps that can be taken in order to prevent these consequences from occurring?
Sarah: Yes. Next steps. So, one of the guidelines on the Acetaminophen Labelling Act is that products containing acetaminophen have the warning “contains acetaminophen” on the bottle so that it’s visible. And when I first read this guideline I immediately went to Google and image searched Tylenol, Nyquil, Dayquil, Robitussin bottles, because they all contain acetaminophen and yep, they all have that in the top either left or right corner, usually the right though, corner of the bottle itself, in red letters. It’s there. And it’s something I never noticed.
Lily: I never noticed either.
Sarah: Yeah, even the no name acetaminophen, it even says, “acetaminophen tablets” and then in the top corner it says “contains acetaminophen”. I never thought about it and I never saw it. So when I saw that I just had this moment where I had to immediately go to Google and search it up.
Sarah: So yeah, if you have a fever and you’re exhausted, or you wake up with the worst headache you’ve ever had, the last thing you’re going to want to do is read that carton, or the bottle the capsules come in. You might see the words “contains acetaminophen”, but what will that really mean to you in that moment? Is it something you realistically would consider stopping and Googling? I mean, maybe. But the majority of people don’t do this.
Sarah: And I see, another thing is that I see these labels as kind of like a terms and conditions agreement…which how many people actually read those start to finish? Do you?
Lily: Absolutely not.
Sarah: Ok good because if you would’ve said yes I really would’ve had to rework this whole entire point [laughs]…but yeah this is something we’re putting in our systems, so why are we still not taking it seriously when the information we need to know and the risks are right there?
Sarah: And I don’t think these medications should be removed as over the counter drugs, because the truth is the majority of people are able to use this drug without any incident whatsoever, so a lot of, a question that can come up is “what’s the point?”. But those statistics speak volumes, 50% of cases being accidental, and 50% of liver failure cases caused by acetaminophen. And that’s a really really big deal.
Sarah: So when I think about the next steps, I don’t see a need to push for more regulation, because what we have right now is really fantastic compared to fifteen years ago, or compared to thirty years ago. I really really think the importance is more education, I never learned this in school. Was this something you learned because you’re pursuing the sciences?
Lily: No it’s never been brought up in any of my science courses.
Sarah: Yeah and that’s crazy to me and the thing is this is a huge topic for conversation right now, what schools are teaching, and what should be implemented to curriculum in Ontario and just everywhere.
Sarah: So I think a realistic answer is that this needs to be integrated into the health curriculum because this medication isn’t going to go away. I started taking Tylenol at my own discretion when I was about thirteen…I don’t know, were you the same, were you similar?
Lily: Yeah.
Sarah: Yeah so, and that was after I was warned, and you were wanted as well and I knew I could take 1 every 4 hours. Kids should know this information, or just at minimum the importance of reading terms, reading labels, understanding what we’re agreeing to. And I really think there’s a lack of this right now. That education is beneficial not only for over the counter awareness but also nutrition, technology, so many things really. And I hate to be all “we’re raising the next generation” because it always sounds really cheesy but we are. We are the parents who will be dosing medication to our future kids. So that’s where I think we should be going in terms of next steps. And we need to understand that just because a product is available for purchase doesn’t mean we can’t just use it.
Lily: Yeah, that's a really great point. I really remember kids, especially in elementary school, middle school, that started bringing things like Advil and Tylenol to school every day. Do they really know what they’re doing?
Sarah: Same with me, yeah.
Lily: Yeah so I think schools implementing that is a really great idea. We should be teaching that in the health curriculum.
Sarah: Yeah.
Lily: That totally can be implemented.
Sarah: Yeah I know, I know how to square dance but I don’t know how to do my taxes.
Lily: Yeah [laughs]
Sarah: Yeah it’s insane to me, but there’s just so much that could be taught on this subject.
Lily: Yeah. It’s a really good point.
Lily: To finish this off, what have you learned yourself from writing this paper and how can you use this information in certain aspects of your life?
Sarah: So as I was doing - this is a great story - as I was doing some of the research for this paper I was sitting at my kitchen table and I got up to take Tylenol because I wasn’t feeling well. But instead of just going ahead and taking that caplet I took the bottle, and I brought it to the table with me, and I put it in front of me and just stared at it. And that’s when I read the label, like start to finish, like I peeled - cause you can peel the bottle - and it gives you like, the longer, terms?
Lily: Yeah
Sarah: You know what I mean? And that was for the first time ever. And I realized as I was reading it, I had never done it before. Ever. And that changed a lot for me in that moment and will really really impact how I look at over the counter medications moving forward.
[Transition Elevator Chime]
Sarah: Are we done?
Lily: Yeah
Sarah: Ok good cause I can’t breathe [laughs] I never knew how difficult this would be
Sarah: This podcast was created by us, written by us, hosted by us, edited by us and produced by us.
Lily: We hope you were able to learn more about the process of scientific miscommunication and about our individual research studies. For more information, our studies will be linked with the show notes, along with all of our sources.
Sarah: In regular podcast outro fashion, we would urge you right about now to listen to next week's episode, but we won’t be producing one. Thank you so much for listening to us talk for an hour.
[Outro Elevator Music]