How do the media report cancer research? A study of the UK's BBC website

Association of travel time, patient characteristics, and hospital quality with patient mobility for breast cancer surgery: A national population-based study

BACKGROUND

This national study investigated hospital quality and patient factors associated with treatment location for breast cancer surgery.

METHODS

By using linked administrative data sets from the English National Health Service, the authors identified all women diagnosed between January 2, 2016, and December 31, 2018, who underwent breast-conserving surgery (BCS) or a mastectomy with or without immediate breast reconstruction. The extent to which patients bypassed their nearest hospital was investigated using a geographic information system (ArcGIS). Conditional logistic regressions were used to estimate the impact of travel time, hospital quality, and patient characteristics.

RESULTS

22,622 Of 69,153 patients undergoing BCS, 22,622 (32.7%) bypassed their nearest hospital; and, of 23,536 patients undergoing mastectomy, 7179 (30.5%) bypassed their nearest hospital. Women who were younger, without comorbidities, or from rural areas were more likely to travel to more distant hospitals (p < .05). Patients undergoing BCS (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.36-2.50) or mastectomy (OR, 1.52; 95% CI, 1.14-2.02) were more likely to be treated at specialist breast reconstruction centers despite not undergoing the procedure. Patients receiving mastectomy and immediate breast reconstruction were more likely to travel to hospitals employing surgeons who had a media reputation (OR, 2.41; 95% CI, 1.28-4.52). Patients undergoing BCS were less likely to travel to hospitals with shorter surgical waiting times (OR, 0.65; 95% CI, 0.46-0.92). The authors did not observe a significant impact for research activity, hospital quality rating, breast re-excision rates, or the status as a multidisciplinary cancer center.

CONCLUSIONS

Patient choice policies may drive inequalities in the health care system without improving patient outcomes.

How Government Health Agencies Obscure the Impact of Environmental Pollution and Perpetuate Reductionist Framings of Disease: The Case of Leukemia

Since the 1970s, environmental health researchers have documented environmental pollution's impacts on human health, which includes the bioaccumulation of industrial chemicals and how these toxicants contribute to disease. However, the relationship between disease and pollution is often difficult to discern in the disease information provided by dominant institutions. Previous scholarship has identified that print media, television news, online medical publishers, and medical associations consistently obscure the environmental causation frame. However, less has been said about disease information provided by public health agencies. To address this gap, I analyzed the leukemia information provided by Cancer Australia, the United States' National Institutes of Health, and the United Kingdom's National Health Service. My analysis shows that the disease information offered by these health agencies also obscures the environmental causation frame by failing to identify most toxicants that environmental health researchers have linked to leukemia and by emphasizing a biomedical framing of the medical condition. Beyond documenting the problem, this article also discusses the social consequences and sources of the problem.

Media coverage of cancer therapeutics: A review of literature

BACKGROUND

Information and stories about cancer treatment are increasingly available to patients and the general public through lay media, websites, blogs and social media. While these resources may be helpful to supplement information provided during physician-patient discussions, there is growing concern about the extent to which media reports accurately reflect advances in cancer care. This review aimed to understand the landscape of published research which has described media coverage of cancer treatments.

METHODS

This literature review included peer-reviewed primary research articles that reported how cancer treatments are portrayed in the lay media. A structured literature search of Medline, EMBASE and Google Scholar was performed. Potentially eligible articles were reviewed by three authors for inclusion. Three reviewers, each independently reviewed eligible studies; discrepancies were resolved by consensus.

RESULTS

Fourteen studies were included. The content of the eligible studies reflected two thematic categories: articles that reviewed specific drugs/cancer treatment (n = 7) and articles that described media coverage of cancer treatment in general terms (n = 7). Key findings include the media's frequent and unfounded use of superlatives and hype for new cancer treatments. Parallel to this, media reports over-emphasize potential treatment benefits and do not present a balanced view of risks of side effects, cost, and death. At a broad level, there is emerging evidence that media reporting of cancer treatments may directly impact patient care and policy-making.

CONCLUSIONS

This review identifies problems in current media reports of new cancer advances - especially with undue use of superlatives and hype. Given the frequency with which patients access this information and the potential for it to influence policy, there is a need for additional research in this space in addition to educational interventions with health journalists. The oncology community - scientists and clinicians - must ensure that we are not contributing to these problems.

Cardiovascular and cancer risk factors analysis for 2001–2020 from the global research output and European newspapers

Cancer and cardiovascular disease (CVD) are now two of the leading components of the global burden of disease, especially in high- and upper-middle-income countries. Causes of the diseases that are amenable to intervention are multiple: tobacco control closely followed by obesity treatment, including promotion of a healthy diet and physical exercise, remain the global priorities. We interrogated the Web of Science (WoS) from 2001 to 2020 to determine the numbers of papers describing research into 14 different possible risk factors causing the two diseases. These ranged in relative importance from tobacco and being overweight to the consumption of excessively hot drinks (linked to oesophageal cancer), pollution (linked to lung cancer particularly) and also non-interventional genetic risks. The risks varied between different continental regions, and obesity has increased as a risk factor for CVD in some of these regions. Because many of these factors are subject to human behavioural choices, we also investigated how such research was being presented to the European public through newspaper reportage. About 40% of the factors that influence the cancer burden can be attributed to particular causes, and more than 85% of those factors influencing CVD can also be so attributed. They are led by tobacco use as a risk factor for cancer, but this is slowly declining in most high-income settings. For CVD, the major risks are metabolic, such as high systolic blood pressure and high body-mass index, but also from tobacco use. Research outputs on some of these different factors in the continental regions correlated positively with their influence on the disease burdens. The selection of European newspaper stories was biased towards those risk factors that could be considered as being under the control of their readers. Reports of research in the mass media have an important role in the control of both cancer and CVD, and should be regarded by public health authorities as a useful means to promulgate health education. This paper is based on one presented at the ISSI conference in Leuven in July 2021 (Pallari and Lewison, in: Glänzel et al (eds) Proceedings of the 18th international conference on scientometrics and informetrics, 2021), but has been extended to cover CVD as well as cancer. The geographical analysis of risk factors and research publications has also been modified.

Evaluating cancer research impact: lessons and examples from existing reviews on approaches to research impact assessment

BACKGROUND

Performing cancer research relies on substantial financial investment, and contributions in time and effort from patients. It is therefore important that this research has real life impacts which are properly evaluated. The optimal approach to cancer research impact evaluation is not clear. The aim of this study was to undertake a systematic review of review articles that describe approaches to impact assessment, and to identify examples of cancer research impact evaluation within these reviews.

METHODS

In total, 11 publication databases and the grey literature were searched to identify review articles addressing the topic of approaches to research impact assessment. Information was extracted on methods for data collection and analysis, impact categories and frameworks used for the purposes of evaluation. Empirical examples of impact assessments of cancer research were identified from these literature reviews. Approaches used in these examples were appraised, with a reflection on which methods would be suited to cancer research  impact evaluation going forward.

RESULTS

In total, 40 literature reviews were identified. Important methods to collect and analyse data for impact assessments were surveys, interviews and documentary analysis. Key categories of impact spanning the reviews were summarised, and a list of frameworks commonly used for impact assessment was generated. The Payback Framework was most often described. Fourteen examples of impact evaluation for cancer research were identified. They ranged from those assessing the impact of a national, charity-funded portfolio of cancer research to the clinical practice impact of a single trial. A set of recommendations for approaching cancer research impact assessment was generated.

CONCLUSIONS

Impact evaluation can demonstrate if and why conducting cancer research  is worthwhile. Using a mixed methods, multi-category assessment organised within a framework, will provide a robust evaluation, but the ability to perform this type of assessment may be constrained by time and resources. Whichever approach is used, easily measured, but inappropriate metrics should be avoided. Going forward, dissemination of the results of cancer research impact assessments will allow the cancer research community to learn how to conduct these evaluations.

Cancer in the news: Bias and quality in media reporting of cancer research

Cancer research in the news is often associated with sensationalised and inaccurate reporting, which may give rise to false hopes and expectations. The role of study selection for cancer-related news stories is an important but less commonly acknowledged issue, as the outcomes of primary research are generally less reliable than those of meta-analyses and systematic reviews. Few studies have investigated the quality of research that makes the news and no previous analyses of the proportions of primary and secondary research in the news have been found in the literature. We analysed distribution of study types, research sources, reporting quality, gender bias, and national bias in online news reports by four major news outlets in USA, UK and Australia over six-months. We measured significant variation in reporting quality and observed biases in many aspects of cancer research reporting, including the types of study selected for coverage, the spectrum of cancer types, gender of scientists, and geographical source of research represented. We discuss the implications of these findings for guiding accurate, contextual reporting of cancer research, which is critical in helping the public understand complex science, appreciate the outcomes of publicly-funded research, maintain trust, and assist informed decision-making. The striking gender bias observed may compromise high-quality coverage of research by limiting diversity of opinion, reinforces stereotypes and skews public visibility and recognition towards male scientists. Our findings provide useful guidelines for scientists and journalists alike to consider in providing the most informative and accurate reporting of research.

Body changes after cancer: female cancer patients' perceived social support and their perspective on care

PURPOSE

The aim of this study was to investigate among female cancer patients their perceived social support from health care professionals (HCPs), family and friends, and public media, and their perspective on care concerning body changes.

METHODS

A study-specific questionnaire was completed by 235 female cancer patients. Descriptive statistics were used to describe social support and perspective on care. Logistic regression analyses were used to investigate the associations between social support and sociodemographic and clinical factors, psychosocial impact, and importance of appearance.

RESULTS

More than half of the patients received sufficient support from HCPs (54%) and family and friends (55%), and a third from the media (32%). Higher educated patients and those who found appearance not important during illness perceived lower support from HCPs. Patients without a partner, and those with a surgical treatment only, perceived lower support from family and friends. Patients who were older, higher educated, without a partner, and those who found appearance not important during illness perceived lower support from the media. In total, 15-50% of the patients received sufficient care for different domains of body changes. Patients expressed the highest need for psychological support (28%) and nutrition (28%).

CONCLUSIONS

Half of the female cancer patients reported to receive sufficient social support concerning body changes after cancer. Perceived support depended on age, education, relationship status, and treatment modality. The need for more care was moderate.

An Automatic Method to Identify Citations to Journals in News Stories: A Case Study of UK Newspapers Citing Web of Science Journals

Purpose

Communicating scientific results to the public is essential to inspire future researchers and ensure that discoveries are exploited. News stories about research are a key communication pathway for this and have been manually monitored to assess the extent of press coverage of scholarship.

Design/methodology/Approach

To make larger scale studies practical, this paper introduces an automatic method to extract citations from newspaper stories to large sets of academic journals. Curated ProQuest queries were used to search for citations to 9,639 Science and 3,412 Social Science Web of Science (WoS) journals from eight UK daily newspapers during 2006–2015. False matches were automatically filtered out by a new program, with 94% of the remaining stories meaningfully citing research.

Findings

Most Science (95%) and Social Science (94%) journals were never cited by these newspapers. Half of the cited Science journals covered medical or health-related topics, whereas 43% of the Social Sciences journals were related to psychiatry or psychology. From the citing news stories, 60% described research extensively and 53% used multiple sources, but few commented on research quality.

Research Limitations

The method has only been tested in English and from the ProQuest Newspapers database.

Practical implications

Others can use the new method to systematically harvest press coverage of research.

Originality/value

An automatic method was introduced and tested to extract citations from newspaper stories to large sets of academic journals.

The Use of Anecdotal Information in a Hypothetical Lung Cancer Treatment Decision

This mixed-methods study examined variables associated with use of experience-based (i.e., anecdotal) decisional strategies among 85 undergraduate students presented with 2 hypothetical lung cancer scenarios. Participants were asked to think aloud while they made their treatment choice. Eleven decisional strategies were identified and grouped into either data or experience-based strategies. Approximately, 25% of participants used experience-based strategies. Use of experience-based strategies was more likely if the participant reported involvement in the life of someone going through cancer treatment, and if they rated print-based media sources as less important. Use of experience-based strategies was associated with choosing surgery instead of radiation for lung cancer treatment.

The evaluation of mental disorders research reported in British and Irish newspapers between 2002 and 2013, and a comparison with the relative disease burdens and with research outputs in the two countries

Mental disorders are a major contributor to the disease burden in Europe. We studied how research on them was communicated to British and Irish newspaper readers through an analysis of stories in the Daily Mail (DML) and The Guardian (GDN) in the UK and the Irish Times (IET) in Ireland, in 2002-13, and whether the coverage reflected the relative burdens of mental disorders, or the amount of research, in the two countries. The cited papers were identified through the newspapers' archive or the Factiva database, and their details and those of the research they cited from the Web of Science, with 1,128 stories in total. Alzheimer's and other dementias was the leading UK press research topic, but depression was for Ireland. The countries whose research was most cited were the United States, followed by Canada and Europe, notably the UK and Ireland in their respective newspapers. Over 68% of the Irish research papers cited by IET were supported by the state, compared with only 38% of all Irish mental disorders research. The UK newspapers had many stories on lifestyle factors (DML) or drug treatments (GDN); IET gave more space to epidemiology. The UK papers gave little attention to non-drug treatments. Many stories quoted commentators, who in the UK were often charities, but the IET tended to use academics.

UK newspaper reporting of the NHS cancer drugs fund, 2010 to 2015: a retrospective media analysis

Objective We wished to explore how UK national newspapers had covered the creation and operation of the Cancer Drugs Fund from 2010 to 2015. This was introduced to provide cancer patients in England with access to drugs not appraised or approved by the National Institute for health and Care Excellence. Design We sought stories in nine newspapers from the Factiva database, and copied their salient details to a spreadsheet. They were categorised by whether they were supportive or critical of the Cancer Drugs Fund and their main arguments, which drugs they mentioned and for which cancers. Settings Not applicable Participants Not applicable Main outcome results Press coverage was mainly very positive, arguing for the Cancer Drugs Fund's extension to Scotland and Wales, and a bigger budget, but neglecting the lack of patient benefit and the severe side effects that sometimes occurred. Leading this support was the Daily Mail, whose influence (measured by the product of number of stories and the paper's circulation) was almost greater than that of the other newspapers combined. Results Press coverage was mainly very positive, arguing for the Cancer Drugs Fund's extension to Scotland and Wales, and a bigger budget, but neglecting the lack of patient benefits and the severe side effects that sometimes occurred. Leading this support was the Daily Mail, whose influence (measured by the product of number of stories and the paper's circulation) was almost greater than that of the other newspapers combined. Conclusions Although there was some critical analysis of the Cancer Drugs Fund, our analysis shows that most press coverage was largely positive and unrepresentative in comparison with the lack of overall benefits to patients and society. It is likely that it contributed to the Cancer Drugs Fund's continuation despite mounting evidence of its ineffectiveness.

Mapping the European cancer research landscape: An evidence base for national and Pan-European research and funding

BACKGROUND

Cancer research is among the most active biomedical research domains for the European Union (EU). However, little quantitative empirical evidence is available to guide the decisions on the choice of disease site to study, specific research domain focus or allocation of research resources. To inform national/supranational cancer research policy, high-resolution intelligence is needed.

METHODS

We performed a bibliometric analysis of European cancer research papers in the Web of Science from 2002 to 2013 to quantify research activity in each of the 28 EU Member States, along with Iceland, Norway and Switzerland (EUR31), which cancer sites/research domains they addressed, and their sources of financial support (2009-2013).

FINDINGS

Cancer research papers from EUR31 correlated well with national Gross Domestic Products (r² = 0.94). However, certain cancer sites (lung, oesophagus and pancreas) were under-researched relative to their disease burden, whereas central nervous system and blood cancers were more generously supported than their burden would warrant. An analysis of research domains indicated a paucity of research on radiotherapy (5%), palliative care (1.2%) and quality of life (0.5%). European cancer research funding in 2012-2013 amounted to ∼€7.6 billion and came from diverse sources, especially in western Europe/Scandinavia, where in nine countries the charitable sector outspent the government but not in Eastern Europe where charitable research funding barely exists.

INTERPRETATION

Several countries need to increase their cancer research outputs substantially, and/or alter their research portfolios to better match their growing (and changing) cancer burden. More co-ordination among funding agencies is required, so that resources can be attuned to align activities to research gaps and perceived clinical needs. In Eastern Europe, the charitable funding sector needs to be developed, so that both public and patient advocacy can have an active role in research.

How is chronic non-communicable respiratory conditions research reported in European newspapers? An impact assessment for policy

BACKGROUND

Newspapers are an important means for the communication of medical research findings to policy-makers and the public, but may distort their views on the relative importance of research into, and burden from, different respiratory diseases.

METHODS

A systematic search strategy based on respiratory-related keywords was developed and translated into 15 European languages to identify relevant stories in 26 newspapers from eight countries in 2002-2013. Details of the stories were recorded on Excel and coded based on the reported respiratory conditions (asthma, chronic obstructive pulmonary disease (COPD) and other) and research types. Each cited research study was identified on the Web of Science and downloaded for analysis.

FINDINGS

There were far more stories about asthma than on COPD, although the amount of research was only modestly greater, and the disease burden far less. Epidemiology, lifestyle and genetics research received the most media attention but not in all newspapers, while means of diagnosis and quality of life were under-reported in all newspapers. Journalists tended to over-cite research from their country by a factor averaging four times more than other researchers. About 10% of stories included a quote from a commentator, especially those in the two UK newspapers, with most of the quotes from UK charities.

CONCLUSIONS

The balance between disease areas reported in European newspaper stories is very misleading. European policy-makers and public may perceive asthma as more burdensome than it is and COPD much less. The study also showed that UK charities, but not those in other European countries, gained significant publicity from their contributions to these stories.

Country over-citation ratios

There is a clear tendency for authors of scientific papers to over-cite the papers by their fellow countrymen (and countrywomen) relative to the percentage presence of their papers in world output in the same field. We investigated the Over-Citation Ratio (OCR) as a function of this percentage, and the effects of different scientific fields and publication years. For cancer research, we also compared clinical with basic research. We found that the OCR for a given percentage presence has been decreasing over the period 1980–2010, probably because of better communications. It is greater for fields of relatively more national interest (chemistry, ornithology) and less for those of international concern (astronomy, diabetes, cancer). It may also be slightly greater for basic cancer research than for clinical work. The OCR values given allow other types of citation, such as the references on clinical practice guidelines and papers featured in newspaper stories, to be put in context: are they unusually nationalistic, or typical of normal citation behaviour?

Health-related knowledge of primary prevention of cancer in Portugal

The increasing number of new cases of cancer highlights the relevance of primary prevention for cancer control, which is influenced, among other factors, by the population’s health-related knowledge. Therefore, we aimed to describe cancer-related knowledge in Portugal, including perception of risk, awareness of cancer causes and preventive behaviours. We evaluated 1624 Portuguese-speaking dwellers, aged between 16 and 79 years, through face-to-face interviews conducted using a structured questionnaire. We computed adjusted (sex, age, education) regression coefficients and prevalence ratios, using linear and Poisson regression, respectively, to quantify associations with cancer-specific knowledge. The proportions of nonresponse ranged from 13.4 to 63.5% for the most frequent cancer in Portugal and the leading cause of cancer, respectively. The mean of the estimated lifetime risk of cancer in the Portuguese population was 37.0%. A total of 47.5% of the respondents identified breast cancer as the most frequent in Portugal, 72.0% named lifestyles as the leading cause of cancer and 40.2% selected not smoking as the most important preventive behaviour. Lower levels of education were associated with higher proportions of nonresponse, but not consistently with inaccurate knowledge. Men provided lower estimates of the lifetime risk of cancer, indicated breast cancer less frequently and more often lung cancer as the most frequent, and were more likely to select not smoking as the most important preventive behaviour. The present study provides relevant data on knowledge of cancer prevention, which may be used for the planning and evaluation of awareness-raising and primary prevention interventions in Portugal.

The State of Lung Cancer Research: A Global Analysis

INTRODUCTION

Lung cancer is the leading cause of years of life lost because of cancer and is associated with the highest economic burden relative to other tumor types. Research remains at the cornerstone of achieving improved outcomes of lung cancer. We present the results of a comprehensive analysis of global lung cancer research between 2004 and 2013 (10 years).

METHODS

The study used bibliometrics to undertake a quantitative analysis of research output in the 24 leading countries in cancer research internationally on the basis of articles and reviews in the Web of Science (WoS) database.

RESULTS

A total of 32,161 lung cancer research articles from 2085 different journals were analyzed. Lung cancer research represented only 5.6% of overall cancer research in 2013, a 1.2% increase since 2004. The commitment to lung cancer research has fallen in most countries apart from China and shows no correlation with lung cancer burden. A review of key research types demonstrated that diagnostics, screening, and quality of life research represent 4.3%, 1.8%, and 0.3% of total lung cancer research, respectively. The leading research types were genetics (20%), systemic therapies (17%), and prognostic biomarkers (16%). Research output is increasingly basic science, with a decrease in clinical translational research output during this period.

CONCLUSIONS

Our findings have established that relative to the huge health, social, and economic burden associated with lung cancer, the level of world research output lags significantly behind that of research on other malignancies. Commitment to diagnostics, screening, and quality of life research is much lower than to basic science and medical research. The study findings are expected to provide the requisite knowledge to guide future cancer research programs in lung cancer.

A standardised, generic, validated approach to stratify the magnitude of clinical benefit that can be anticipated from anti-cancer therapies: the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS)

The value of any new therapeutic strategy or treatment is determined by the magnitude of its clinical benefit balanced against its cost. Evidence for clinical benefit from new treatment options is derived from clinical research, in particular phase III randomised trials, which generate unbiased data regarding the efficacy, benefit and safety of new therapeutic approaches. To date, there is no standard tool for grading the magnitude of clinical benefit of cancer therapies, which may range from trivial (median progression-free survival advantage of only a few weeks) to substantial (improved long-term survival). Indeed, in the absence of a standardised approach for grading the magnitude of clinical benefit, conclusions and recommendations derived from studies are often hotly disputed and very modest incremental advances have often been presented, discussed and promoted as major advances or 'breakthroughs'. Recognising the importance of presenting clear and unbiased statements regarding the magnitude of the clinical benefit from new therapeutic approaches derived from high-quality clinical trials, the European Society for Medical Oncology (ESMO) has developed a validated and reproducible tool to assess the magnitude of clinical benefit for cancer medicines, the ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS). This tool uses a rational, structured and consistent approach to derive a relative ranking of the magnitude of clinically meaningful benefit that can be expected from a new anti-cancer treatment. The ESMO-MCBS is an important first step to the critical public policy issue of value in cancer care, helping to frame the appropriate use of limited public and personal resources to deliver cost-effective and affordable cancer care. The ESMO-MCBS will be a dynamic tool and its criteria will be revised on a regular basis.

"It's not healthy and it's decidedly not masculine": a media analysis of UK newspaper representations of eating disorders in males

OBJECTIVES

Recent qualitative research found young men reporting that an expectation that eating disorders (EDs) mainly affect young women led them, and others, to only recognise their symptoms when their ED had become entrenched. This raises questions about how these stereotypes persist. We therefore explored how EDs in males were represented in articles published in UK newspapers over a 10-year period (7.12.2002-7.12.2012), specifically attending to whether newsprint media represent EDs in males as 'gender appropriate', 'gender anomalous' or 'gender neutral'.

DESIGN

A qualitative thematic analysis of UK newspaper articles.

METHODS

We searched two databases, Newsbank and LexisNexis, for newspaper articles including ED and male terms in the lead/first paragraph. Following de-duplication, 420 articles were scrutinised; 138 met inclusion criteria for detailed textual analysis and were imported into NVivo10.

FINDINGS

The number of articles peaked in 2008 when a UK politician announced that he had experienced bulimia nervosa. Analysis of how the articles portrayed male ED-related characterisations and experiences revealed that they conveyed ambiguous messages about EDs in males. Despite apparently aiming to dispel stereotypes that only young women experience EDs and to address stigma surrounding EDs in males, many aspects of the articles, including repetition of phrases such as 'a young woman's illness', serve to reinforce messages that EDs are inherently 'female' and so 'anomalous' for men.

CONCLUSIONS

Newspaper articles represent men with EDs as atypical of men, as a result of having an ED (and any feminising or demasculinising characteristics associated with this), and as atypical of people with EDs, who are still usually portrayed as teenage girls. Such media representations frame a cultural paradigm in which there is an expectation that men may feel shame about or strive to conceal EDs, potentially contributing to men with EDs delaying help-seeking, gaining late access to treatments and reducing chances of successful outcomes.

Pharmacogenetics and the print media: what is the public told?

BACKGROUND

Pharmacogenetics is a rapidly growing field that aims to identify the genes that influence drug response. This science can be used as a powerful tool to tailor drug treatment to the genetic makeup of individuals. The present study explores the coverage of the topic of pharmacogenetics and its potential benefit in personalised medicine by the UK newsprint media.

METHODS

The LexisNexis database was used to identify and retrieve full text articles from the 10 highest circulation national daily newspapers and their Sunday equivalents in the UK. Content analysis of newspaper articles which referenced pharmacogenetic testing was carried out. A second researcher coded a random sample (21%) of newspaper articles to establish the inter-rater reliability of coding.

RESULTS

Of the 256 articles captured by the search terms, 96 articles (with pharmacogenetics as a major component) met the study inclusion criteria. The majority of articles over-stated the benefits of pharmacogenetic testing while paying less attention to the associated risks. Overall beneficial effects were mentioned 5.3 times more frequently than risks (p < 0.001). The most common illnesses for which pharmacogenetically based personalised medicine was discussed were cancer, cardiovascular disease and CNS diseases. Only 13% of newspaper articles that cited a specific scientific study mentioned this link in the article. There was a positive correlation between the size of the article and both the number of benefits and risks stated (P < 0.01).

CONCLUSION

More comprehensive coverage of the area of personalised medicine within the print media is needed to inform public debate on the inclusion of pharmacogentic testing in routine practice.

Measuring the outcome of biomedical research: a systematic literature review

BACKGROUND

There is an increasing need to evaluate the production and impact of medical research produced by institutions. Many indicators exist, yet we do not have enough information about their relevance. The objective of this systematic review was (1) to identify all the indicators that could be used to measure the output and outcome of medical research carried out in institutions and (2) enlist their methodology, use, positive and negative points.

METHODOLOGY

We have searched 3 databases (Pubmed, Scopus, Web of Science) using the following keywords: [Research outcome* OR research output* OR bibliometric* OR scientometric* OR scientific production] AND [indicator* OR index* OR evaluation OR metrics]. We included articles presenting, discussing or evaluating indicators measuring the scientific production of an institution. The search was conducted by two independent authors using a standardised data extraction form. For each indicator we extracted its definition, calculation, its rationale and its positive and negative points. In order to reduce bias, data extraction and analysis was performed by two independent authors.

FINDINGS

We included 76 articles. A total of 57 indicators were identified. We have classified those indicators into 6 categories: 9 indicators of research activity, 24 indicators of scientific production and impact, 5 indicators of collaboration, 7 indicators of industrial production, 4 indicators of dissemination, 8 indicators of health service impact. The most widely discussed and described is the h-index with 31 articles discussing it.

DISCUSSION

The majority of indicators found are bibliometric indicators of scientific production and impact. Several indicators have been developed to improve the h-index. This indicator has also inspired the creation of two indicators to measure industrial production and collaboration. Several articles propose indicators measuring research impact without detailing a methodology for calculating them. Many bibliometric indicators identified have been created but have not been used or further discussed.

Drugs, cancer and end-of-life care: a case study of pharmaceuticalization?

There is evidence from some countries of a trend towards increasingly aggressive pharmacological treatment of patients with advanced, incurable cancer. To what extent should this be understood as a progressive development in which technological innovations address previously unmet needs, or is a significant amount of this expansion explained by futile or even harmful treatment? In this article it is argued that while some of this growth may be consistent with a progressive account of medicines consumption, part of the expansion is constituted by the inappropriate and overly aggressive use of drugs. Such use is often explained in terms of individual patient consumerism and/or factors to do with physician behaviour. Whilst acknowledging the role of physicians and patients' expectations, this paper, drawing on empirical research conducted in the US, the EU and the UK, examines the extent to which upstream factors shape expectations and drive pharmaceuticalisation, and explores the value of this concept as an analytical tool.

How do medical journalists treat cancer-related issues?

Cancer patients can obtain information about their illness through a variety of media sources. Therefore, it is important to know how medical journalists treat cancer-related issues; to that end, we sent self-administered questionnaires to 364 journalists in 82 organisations who had reported on medical issues for the Japanese media, asking for their reasons for reporting on cancer-related issues and the difficulties they had faced. The most common reason for reporting on health-related issues was their personal interest in a particular issue (n = 36). They mainly covered conventional therapies (n = 33), healthcare policy (n = 30), new therapies (n = 25), and diagnosis (n = 25). All of the journalists that were surveyed experienced some difficulties in reporting health issues. Significant concerns included the quality of information (n = 36), social impact (n = 35), lack of technical knowledge (n = 35), and difficulty in understanding technical terms (n = 35). Journalists commonly used personal networks, including physicians, as information sources (n = 42), as well as social media (e.g., e-mail, Twitter and Facebook) (n = 32). Topic selection was biased, with 35 of 48 journalists having never reported on topics concerning hospices. Physicians were the most trusted source of information about cancer, and journalists attached high importance to interviewing them. As medical knowledge is advancing rapidly, journalists may have increasing difficulty covering cancer-related issues.

The contribution of media analysis to the evaluation of environmental interventions: the commuting and health in Cambridge study

Background

Media content can increase awareness of, and shape interactions with, public health interventions. As part of a natural experimental evaluation of the travel, physical activity and health impacts of the Cambridgeshire Guided Busway, we analysed print and social media discourse and interview data to understand the nature of new transport infrastructure and how it was experienced.

Methods

Newspaper articles were systematically retrieved from the LexisNexis database and tweets were identified from an online archive. Interviews were conducted as part of the larger evaluation study with 38 adults. Inductive thematic analysis was performed and comparisons were drawn between datasets.

Results

The findings are discussed in relation to five themes. First, an understanding of the intervention context and how the intervention was experienced was developed through accounts of events occurring pre and post the busway’s opening. Second, the media captured the dynamic nature of the intervention. Third, the media constructed idealised portrayals of the anticipated busway which in some cases were contradicted by the impact of the busway on the existing context and people’s lived experiences. Fourth, differential media coverage of the intervention components suggested that a lesser value was placed on promoting active travel compared with public transport. Lastly, interview data provided support for the hypothesis that the media increased awareness of the busway and served as a frame of reference for constructing expectations and comparing experiences.

Conclusions

This analysis has contributed to the wider evaluation of the busway, helping to understand its nature and implementation and informing hypotheses about how the local population interact with the infrastructure by attending to the significance of representations in the media.

The media and cancer: education or entertainment? An ethnographic study of European cancer journalists

The media plays a vital role in informing the public about new developments in cancer research and influencing cancer policy. This is no easy task, in view of the myriad of trials and wonder drugs that purport to be the 'magic bullet'. However, misrepresentation can have profound consequences. In this qualitative study, we sought to understand the interaction between the media and cancer through the perspective of European science journalists by defining their attitudes towards current cancer research and challenges faced when reporting science news. A total of 67 respondents took part in this online survey, which was distributed by the European CanCer Organisation (ECCO) to all its media contacts between June and September 2013. Fifty-three per cent had over 20 years experience in reporting science news stories. The respondents utilised a number of media formats, including newsprint, online services, and radio. Fifty per cent ranked public interest as the greatest influence on their selection of cancer research topics, followed by topicality. Respondents were conscious of being fed ambiguous and exaggerated results from trials by the research community. Sixty-five per cent of respondents would appreciate access to a forum of experts willing to provide comment on new research findings. Seventy per cent highlighted the importance of prompt responses from scientists and researchers during correspondence, and the need to have advance warning of new developments (49%). To conclude - coverage of cancer related issues and scientific advances require greater collaboration between the press and cancer healthcare community to provide both credibility and accountability for the health information disseminated. Key areas include a more precise definition of the research context and differentiation of absolute and relative risks, as well as individual and population risks and an informed discussion about the realities and limitations of cancer care and research.

Bevacizumab for advanced breast cancer: hope, hype, and hundreds of headlines

On February 22, 2008, the Food and Drug Administration granted accelerated approval for the use of bevacizumab (Avastin) in metastatic breast cancer. Based on subsequent clinical trials, this approval was revoked on November 18, 2011. In this study, we categorize and analyze the newspaper reports related to bevacizumab's use in advanced breast cancer. Methods. Using the Factiva media database, we reviewed all newspaper reports published in North America from January 4, 2002, to January 4, 2013, containing the words "breast cancer" and "Avastin," or "bevacizumab." Articles were classified as pre-approval (January 4, 2002-February 21, 2008), approval (February 22, 2008-November 17, 2011), or post-approval loss (November 18, 2011-January 4, 2013). Information regarding benefits, side effects, costs, interviewees, and article tone and theme were abstracted from each article by two independent reviewers. Differences among the three study phases were compared using the chi square analysis. Results. A total of 359 articles met study inclusion criteria. The number of reports having a positive headline tone and/or positive article tone declined with each study period. The proportion of articles discussing side effects and financial costs increased, whereas those discussing efficacy decreased with each study period. Drug representatives were most likely to be quoted in newspaper articles prior to bevacizumab's approval. Conclusion. Media reports are a common source of medical information for patients, practitioners, and policy makers. We observed substantial fluidity of media reports over time.

Online cancer news: trends regarding article types, specific cancers, and the cancer continuum

The Internet is one of the fastest growing news sources for many worldwide (Pew Research Center's Project for Excellence in Journalism, 2011), and cancer news is one frequently consumed form of online health information (Google, Inc., 2007). This content analysis of online cancer news (n = 862) retrieved from the four most frequented news websites describes trends regarding specific cancers, stages in the cancer continuum, and types of news articles. In general, treatment information received the most attention in online cancer news. Breast cancer received the most attention of each specific cancer, followed by digestive and genitourinary cancers. Research reports and profiles of people (more than 60% of which were about celebrities) were the most common article types. Risk, uncertainty, and clinical trials were also present across several types of cancer news articles. Implications of content trends are discussed as relevant to consumers, producers, health campaign designers, and researchers alike.

Public health benefits and risks of fish consumption: current scientific evidence v. media coverage

OBJECTIVE

To evaluate if and how the current degree of scientific uncertainty about the safety of fish consumption is incorporated at the media level.

DESIGN

We used a dedicated software (TalTac®) to investigate the content of 169 news articles related to ‘mercury and fish consumption’ that appeared from 1990 to 2010 in the two Italian broadsheets with the highest circulation figures, in order to identify journalistic frames used in the coverage of benefits v. risks associated with fish consumption. Hypotheses were made on how the public might change fish consumption patterns as a result of media coverage.

SETTING

Italy.

RESULTS

The two newspapers have different agendas in covering the issue. La Repubblica appears to support the view that, besides health benefits, there may be risks associated with fish consumption, while Corriere della Sera emphasizes health benefits more than possible risks. Depending on the preferred information source, the public could: (i) reduce its fish intake; (ii) increase its fish intake; or (iii) become confused about the problem and sceptical towards the media, as a result of conflicting journalistic frames.

CONCLUSIONS

The Italian media, in cooperation with scientists, public health nutritionists and dietitians, should place more emphasis on the existence of a few fish species with high to very high Hg levels and relatively low contents of beneficial n-3 fatty acids (e.g. swordfish and shark). This would enable consumers to make more educated purchasing decisions to maximize the benefits of n-3 intake while reducing possible risks from consuming Hg-contaminated fish.

Knowledge of reproductive system cancers, their treatments and side effects

We explored, via an online questionnaire, knowledge of breast and reproductive system cancers in patients and non-patients who access the internet for information on these diseases. We compared that knowledge to the attention the diseases have received in medical research and on the Internet. Data were collected from 690 respondents (37 % male, 63 % female) about their knowledge of prevalence, lethality, treatments and side effects of testicular, prostate, breast, uterine, cervical and ovarian cancers. Most males, but only half of the female participants, were patients themselves. Although participants showed better knowledge of cancers specific to their own sex, both sexes felt familiar with breast cancer and less aware of other cancers. Women were as aware as men of side effects of treatments for male reproductive cancers. Sex differences in awareness appear to reflect different attitudes towards illness, bias toward females as caregivers, and the disproportionate media attention given to breast cancer.

The reporting of mental disorders research in British media

BACKGROUND

While the media may significantly influence public attitudes and government policies affecting the research agenda, how mental health research is reported in the media has been virtually unstudied. The aim of this study was to examine stories concerning mental health research published on the British Broadcasting Corporation (BBC) website between 1999 and 2008 and in New Scientist between 2008 and 2010.

METHOD

Stories were retrieved from on-line archives. Story content was coded and assessed against: 'disease burden' of mental disorders; the general corpus of research papers in mental health and the countries from which they originated; the journals in which cited papers were published; and funding sources.

RESULTS

A total of 1015 BBC stories reporting mental health research and 133 New Scientist stories were found. The distribution of stories did not reflect 'disease burden'; research on dementia was over-represented, while depression and alcohol were under-represented. There was an emphasis on biological research while stories on psychological interventions were rare. UK research was over-represented. Research funded by government and private non-profit sources was over-represented. Commentators from Alzheimer's Disease charities were prominent.

CONCLUSIONS

Consideration of reported stories may suggest approaches to working with the media to improve the public understanding of, and support for, mental health research. The role of commentators may be especially important.

How might the London 2012 Olympics influence health and the determinants of health? Local newspaper analysis of pre-Games pathways and impacts

OBJECTIVES

To conduct a content analysis of pre-Games local media coverage of the potential impact on health and the determinants of health in Newham, the site of the Olympic Park.

DESIGN

Local newspaper content analysis.

SETTING

Olympic park host site of the London Borough of Newham.

OUTCOME MEASURES

Media coverage of employment, physical activity and well-being.

RESULTS

Three hundred and 51 articles meeting the inclusion criteria were included in the analysis. The overwhelming majority of the articles took a positive perspective on the Olympic Games being hosted in Newham with less than 10% (32/351) addressing potential adverse effects. The frequency of articles reporting on both employment and well-being increased significantly over time (p=0.002 and p=0.006, respectively). A non-significant increasing trend was observed for physical activity (p=0.146). New employment opportunities and the promotion of physical activity in young people were the pathways most frequently reported in the local media. However, much less attention is devoted to understanding the uncertainties about how much of these new opportunities will directly improve the determinants of health in the Newham population.

CONCLUSIONS

Pre-Games reporting on the impact on health and the determinants of health increased over time in the London Borough of Newham, and is overwhelmingly positive. However, specific uncertainties around the true nature of its impact on local employment and physical activity were articulated. Further evaluation of the tangible impacts on population health, and the determinants of health and health inequalities from the London 2012 Olympics, is required.

An analysis of research activity in major UK cancer centres

The organisation of cancer research is critical to its overall creativity and productivity. Cancer centres are a major organisational structure for this research, however, little is known about their effect on research or how national policy-making intersects with this complex policy nexus. This study of the evolution of United Kingdom cancer centres (UKCC), part of a wider European and United States programme, uses a bibliometric analysis of research activity prior to the creation of the NCRI and after its formation (1995-2004/5). In terms of critical research mass UKCC are very heterogeneous with a fourfold difference between the top and bottom quintiles. UK centres published just over one eighth of the total UKCC in 1995 but almost a quarter by 2004. This centrification occurred in the absence of any national strategy. Overall these centres conduct more fundamental (laboratory-based) research than that being conducted in the wider network but this hides major heterogeneity. UKCC collaborate with European investigators in 5-28% of all their outputs and with USA the range is between 6% and 21%. We have also derived new measures of research impact on clinical management and the general public as well as the impact of national policy on research assessment for certain types of cancer research.

Coverage of Jade Goody's cervical cancer in UK newspapers: a missed opportunity for health promotion?

BACKGROUND

It has been claimed that publicity surrounding popular celebrity Jade Goody's experience of cervical cancer will raise awareness about the disease. This study examines the content of newspaper articles covering her illness to consider whether 'mobilising information' which could encourage women to adopt risk-reducing and health promoting behaviours has been included.

METHODS

Content analysis of 15 national newspapers published between August 2008 and April 2009

FINDINGS

In the extensive coverage of Goody's illness (527 articles in the 7 months of study) few newspaper articles included information that might make women more aware of the signs and symptoms or risk factors for the disease, or discussed the role of the human papilloma virus (HPV) and the recently introduced HPV vaccination programme to reduce the future incidence of cervical cancer. For example, less than 5% of articles mentioned well-known risk-factors for cervical cancer and less than 8% gave any information about HPV. The 'human interest' aspects of Goody's illness (her treatment, the spread of her disease in later months, her wedding, and her preparations for her children's future) were more extensively covered.

CONCLUSIONS

Newspaper coverage of Goody's illness has tended not to include factual or educational information that could mobilise or inform women, or help them to recognise early symptoms. However, the focus on personal tragedy may encourage women to be receptive to HPV vaccination or screening if her story acts as a reminder that cervical cancer can be a devastating and fatal disease in the longer term.