"Spin Doctors - How the Media Reports on Medicine"
In a study of the dietary advice given by newspapers in the UK,
no credible scientific basis was found for most claims.
The misreporting of dietary advice was found to be widespread
and may contribute to public misconceptions about food and health.
And potentially not just the public.
Scientists like to think that they're not influenced by popular media,
but this study decided to put it to the test.
Each week the New York Times reports on scientific research,
and the studies they report on end up being cited more often
than those they don't report on. Ah, so the popular press does have an impact.
Not so fast. That's just one potential explanation.
Maybe outstanding articles are both more likely to be picked up by media
and independently more likely to be cited.
Maybe the newspaper was just earmarking important science
and their publicity didn't really have any effect on future studies.
How could you disentangle the two? Well, an event in 1978 made it possible.
There was a three-month strike in which they continued to print copies
but could not sell them to the public.
So a natural experiment was set up.
If the paper was just earmarking important articles,
then the strike would have no effect on the studies' impact,
but that's not what happened.
The studies highlighted during the strike months, when no one could read them,
appeared to have no impact.
The next question, of course, is are they just amplifying the medical information
to the scientific community or distorting it as well?
Systematic studies suggest that many stories about new medicines, for example,
tend to overstate benefits, understate risks and costs,
and fail to disclose relevant financial ties.
Overly rosy coverage of drugs may also result from financial ties
between drug companies and the journalists themselves,
who may be susceptible to Big Pharma perks.
Scientists and physicians often blame the press.
In fact the famous physician William Osler was quoted as saying,
"Believe nothing you see in the newspapers, and if you see anything
in them that you know is true, begin to doubt it at once."
But both parties share in the blame.
Now reporters may only have an hour or two to put together a story
and so they may rely on press releases.
And it's not hard to imagine how drug company press releases might be biased.
But surely press releases from the scientists themselves and
their institutions would present the facts fairly and without spin, right?
Researchers decided to put it to the test.
Critics blame the media, but where do you think they're getting the information from?
One might assume that press releases from prestigious
academic medical centers would be measured, unexaggerated,
but suffer from the same problems: downplaying side effects,
conflicts of interest, study limitations,
and promoting research that has uncertain relevance to human health.
For example, most animal or laboratory studies explicitly claimed relevance
to human health, yet lacked caveats about extrapolating results to people.
For example, a release about a study of ultrasound reducing tumors in mice,
was titled "Researchers study the use of ultrasound for treatment of cancer,"
failing to note "for your pet mouse."
Apparently it's been estimated that less than 10% of animal research
ever succeeds in being translated to human clinical use.
Over-selling the results of lab animal studies as a promised cure
potentially confuses readers
and might contribute to disillusionment with science.
Although it is common to blame the media for exaggerations,
most times they don't just make it up.
That's what the research institutions are sending out in their own press releases.
And medical journals, too.
Sometimes medical journal press releases do more harm than good.
An analysis of press releases from some of the most prestigious medical journals
found the same litany of problems.
I don't think most people realize that journals sell what are called reprints,
copies of the articles they print,
to drug companies, which can bring in big bucks,
like drug companies may buy a million copies of a favorable article.
Sometimes the company will submit an article and promise to buy
a certain number in advance, which is effectively a bribe,
notes a long-time editor-in-chief at the prestigious British Medical Journal.
He remembers once when a woman from a public relations company once rang him up
and stopped just short of saying
she would go to bed with him if they published the paper.
Another medical journal conflict of interest relates to advertising,
a major source of income for many journals.
Most of the advertising comes from pharmaceutical companies,
and so if they don't like a study, they can threaten to withdraw their advertising,
potentially leaving editors faced with the stark choice
of agreeing to bury a particular piece or seeing their journal die.
Even if journalists have the time to skip the press releases
and go straight to the source and try to read the studies themselves,
they may find them utterly incomprehensible gobbledygook.
But even if they do understand them, scientific articles are not simply reports of facts.
Authors often have many opportunities to add "spin" to their scientific reports,
defined as ways that can distort the interpretation of results
and mislead readers, either unconsciously or with willful intent to deceive.
What these researchers did was look at randomized controlled trials
with statistically nonsignificant results, meaning some drug, for example,
was compared to a sugar pill and the difference between
the newfangled treatment and placebo was essentially nonexistent.
Would the researcher just lay out the truth, and be like,
'Ah, well, we spent all this time and money,
and in terms of our primary outcome we got nothing.'
Or would they try to spin it?
In 68% of cases they spun.
There was spin in the abstract, which is like the summary of the article,
and this is particularly alarming because the abstract
is often the only part of the article people actually read.
And so no wonder the media often gets it wrong.
Spin in the abstracts can turn into spin in the press releases
and results in spin in the news.
Therefore, even if journalists are doing their due diligence,
using the original abstract conclusion in good faith,
they still run the risk of deceiving their readers.
Researchers presenting new findings could always be careful to stress
how preliminary the findings may be,
but let's be serious: powerful self-interests may prevail.
Finally though, I think the biggest problem with the way media reports
on medicine is the choice as to which stories are covered.
In 2003, SARS and bioterrorism killed less than a dozen people,
yet generated over a 100,000 media reports,
far more than those covering the actual greatest threats to our lives and health.
In fact, ironically, the more people that die,
the less it appears something is covered.
Our leading number one killer is heart disease;
yet it can be prevented, treated, and even reversed with diet and lifestyle changes.
Now that is something that deserves to be on the front page.