Understand the Media
Reporters assigned to the health beat of a broadcaster or newspaper must submit to regular headlines and absolute deadlines. Science seldom obliges with a daily output of exciting news. Pressures to fill space and dramatize the subject are not in the interests of sober reporting. When reading media reports consider the following:
The Nature of the Media – Some news media and broadcasts inspire more trust than others do. Readers should judge the medium’s reputation and independence. Reliability and critical appraisal seems more likely in a national newspaper than in tabloids at the supermarket checkout. Does the outlet have any connection to the news item? For example, does the same issue advertise the reported ‘beneficial’ product?
The Credibility of the Journalist – Does the journalist have a science background or any credential that might assist interpretation of scientific data to the public? A careful reporter will discuss the cons as well as the pros of study results. A good journalist interviews critics as well as the scientists that produce the data. Journalists should try to put research in context and avoid over interpreting results.
The Source of the Information – Readers should insist upon knowing the source of a journalist’s report. For example, pharmaceutical spokespersons are potentially biased sources of drug information. Normally, the researchers producing the data will first present their work at a scientific meeting. This is an important part of the process, but details of the study are sketchy in a 10-minute presentation and peer review is minimal. The real test is when the researchers publish their material in a scientific journal following careful scrutiny by reviewers and editors. The exact source(s) of published data should be included in the media article so the reader may judge their quality, and even look up the original report. Ideally, the journalist should take into account any accompanying editorial and critical letters to the editors in subsequent editions of the scientific journal. A cautious reporter will detail the need for further study to clarify new findings.
Beware of Extravagant Claims – Caveat emptor (Let the buyer beware)! If a news report of medical data seems too good or too outrageous to be true, it probably is. Beware particularly of confusing coincidence with causality. When two phenomena commonly occur together, it does not prove that one causes the other. The human condition is far too complicated to attribute certain diets to certain diseases based on a single observation. Too many other factors are at work. In a proper experiment, researchers try to neutralize or control these so that they do not obscure the results. Of course, associations are important to help generate hypotheses for future studies, but they are seldom worthy of headlines.
A misleading media report may be betrayed by the journalist’s language, or the editor’s headline. Most treatments improve a person’s health, so one should distrust the word “cure.” Despite several instances of dramatic discoveries over the last century (e.g., insulin, penicillin, polio vaccine and a bacterial cause for peptic ulcer), most scientific research is incremental. Contemporary heart treatments, drugs for Crohn’s disease, immunity, and the human genome are taking years to establish. Terms such as “breakthrough,” or “revolutionary” also should be distrusted also. Remember, bloodletting was a common treatment for many diseases for centuries. Its use was due to unwarranted enthusiasm, the placebo effect and the tendency of many diseases to improve. Slow, plodding, and sceptical science is the only sure protection we have against such an outrage.
Beware the Anecdote – Most of us have a friend, or have heard of someone, who claims to be cured by a treatment that has no scientific basis. Faith-based treatments are not necessarily harmful, but if they have adverse effects, or delay effective treatment, they can be so. Journalism thrives on the anecdote, the human-interest story – the attention-grabbing incident that “proves” the point. Nevertheless, anecdotes are poor science. The human condition is far too complex for us to believe that if a treatment works for someone, it is more likely than by chance to work in ourselves. If there must be anecdotes, they should illustrate all possible outcomes.
If there were no placebo effect, and the natural course of diseases and human lives were predictable, there would be no need for clinical trials. The anecdote would reign supreme in medical decision-making. What happened once, in the same circumstance would happen again. However, we need the careful accumulation of medical evidence with all its detours and false starts if we are to understand what benefits our health and what does not. Even if untrained in science, readers can try to understand the scientific method and learn what to believe from media reports. The evidence-based medicine movement aims to remove chance from medical treatments. A healthy skepticism with rejection of sensational health headlines offers some protection against unscientific and exaggerated claims.
Angell M, Kassirer JP. Clinical research - what should the public believe? New Engl J Med 1994; 331:189-191.
Fitzgerald FT. The tyranny of health. New Engl J Med 1994; 331:196-199. Thompson WG. The Placebo Effect in Health: combining science and compassionate care. New York: Prometheus, 2005.
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Adapted from IFFGD Publication #206 by W. Grant Thompson, MD, FRCPC, Emeritus Professor of Medicine, University of Ottawa, Ontario, Canada.
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