The commercialisation of medical and scientific reporting

Beyond belief: a cross-genre study on perception and validation of health information online

Natural language undergoes significant transformation from the domain of specialized research to general news intended for wider consumption. This transition makes the information vulnerable to misinterpretation, misrepresentation, and incorrect attribution, all of which may be difficult to identify without adequate domain knowledge and may exist even in the presence of explicit citations. Moreover, newswire articles seldom provide a precise correspondence between a specific claim and its origin, making it harder to identify which claims, if any, reflect the original findings. For instance, an article stating "Flagellin shows therapeutic potential with H3N2, known as Aussie Flu." contains two claims ("Flagellin ... H3N2," and "H3N2, known as Aussie Flu") that may be true or false independent of each other, and it is prima facie unclear which claims, if any, are supported by the cited research. We build a dataset of sentences from medical news along with the sources from peer-reviewed medical research journals they cite. We use these data to study what a general reader perceives to be true, and how to verify the scientific source of claims. Unlike existing datasets, this captures the metamorphosis of information across two genres with disparate readership and vastly different vocabularies and presents the first empirical study of health-related fact-checking across them.

Cognitive Enhancement: Unanswered Questions About Human Psychology and Social Behavior

Stimulant drugs, transcranial magnetic stimulation, brain-computer interfaces, and even genetic modifications are all discussed as forms of potential cognitive enhancement. Cognitive enhancement can be conceived as a benefit-seeking strategy used by healthy individuals to enhance cognitive abilities such as learning, memory, attention, or vigilance. This phenomenon is hotly debated in the public, professional, and scientific literature. Many of the statements favoring cognitive enhancement (e.g., related to greater productivity and autonomy) or opposing it (e.g., related to health-risks and social expectations) rely on claims about human welfare and human flourishing. But with real-world evidence from the social and psychological sciences often missing to support (or invalidate) these claims, the debate about cognitive enhancement is stalled. In this paper, we describe a set of crucial debated questions about psychological and social aspects of cognitive enhancement (e.g., intrinsic motivation, well-being) and explain why they are of fundamental importance to address in the cognitive enhancement debate and in future research. We propose studies targeting social and psychological outcomes associated with cognitive enhancers (e.g., stigmatization, burnout, mental well-being, work motivation). We also voice a call for scientific evidence, inclusive of but not limited to biological health outcomes, to thoroughly assess the impact of enhancement. This evidence is needed to engage in empirically informed policymaking, as well as to promote the mental and physical health of users and non-users of enhancement.

Individual, institutional, and scientific environment factors associated with questionable research practices in the reporting of messages and conclusions in scientific health services research publications

Background

Health Services Research findings (HSR) reported in scientific publications may become part of the decision-making process on healthcare. This study aimed to explore associations between researcher’s individual, institutional, and scientific environment factors and the occurrence of questionable research practices (QRPs) in the reporting of messages and conclusions in scientific HSR publications.

Methods

We employed a mixed-methods study design. We identified factors possibly contributing to QRPs in the reporting of messages and conclusions through a literature review, 14 semi-structured interviews with HSR institutional leaders, and 13 focus-groups amongst researchers. A survey corresponding with these factors was developed and shared with 172 authors of 116 scientific HSR publications produced by Dutch research institutes in 2016. We assessed the included publications for the occurrence of QRPs. An exploratory factor analysis was conducted to identify factors within individual, institutional, and environmental domains. Next, we conducted bivariate analyses using simple Poisson regression to explore factors’ association with the number of QRPs in the assessed HSR publications. Factors related to QRPs with a p-value < .30 were included in four multivariate models tested through a multiple Poisson regression.

Results

In total, 78 (45%) participants completed the survey (51.3% first authors and 48.7% last authors). Twelve factors were included in the multivariate analyses. In all four multivariate models, a higher score of “pressure to create societal impact” (Exp B = 1.28, 95% CI [1.11, 1.47]), was associated with higher number of QRPs. Higher scores on “specific training” (Exp B = 0.85, 95% CI [0.77–0.94]) and “co-author conflict of interest” (Exp B = 0.85, 95% CI [0.75–0.97]) factors were associated with a lower number of QRPs. Stratification between first and last authors indicated different factors were related to the occurrence of QRPs for these groups.

Conclusion

Experienced pressure to create societal impact is associated with more QRPs in the reporting of messages and conclusions in HSR publications. Specific training in reporting messages and conclusions and awareness of co-author conflict of interests are related to fewer QRPs. Our results should stimulate awareness within the field of HSR internationally on opportunities to better support reporting in scientific HSR publications.

Cancer News Coverage in Korean Newspapers: An Analytic Study in Terms of Cancer Awareness

OBJECTIVES

Cancer diagnoses have a tremendous impact on individuals and communities, drawing intense public concern. The objective of the current research was to examine news coverage and content related to cancer-related issues in Korean newspapers.

METHODS

Primarily using the database system of the Korea Press Foundation, we conducted a content analysis of 2806 articles from 9 Korean daily newspapers during a recent 3-year period from 2015 to 2017. Thematic categories, the types of articles, attitudes and tone, and the number of sources in each article were coded and classified.

RESULTS

Many news articles dealt with a diverse range of themes related to cancer, including general healthcare information, the latest research and development, specific medical institutions and personnel, and technology and products, which jointly accounted for 74.8% of all articles. Those thematic categories differed markedly in terms of article type, tone, and the number of cited sources. News articles provided extensive information about healthcare resources, and many articles seemed to contain advertising content. However, the content related to complex social issues such as National Health Insurance did not include enough information for the reader to contextualize the issues properly or present the issues systematically.

CONCLUSIONS

It can be assumed that the media exert differential influence on individuals through news coverage. Within the present reporting framework, the availability and usefulness of information are likely to depend solely on individuals' capabilities, such as financial and health literacy; this dependency has a negative impact on knowledge gaps and health inequities.

Figure Interpretation Assessment Tool-Health (FIAT-health) 2.0: from a scoring instrument to a critical appraisal tool

BACKGROUND

Statistics are frequently used in health advocacy to attract attention, but are often misinterpreted. The Figure Interpretation Assessment Tool-Health (FIAT-Health) 1.0 was developed to support systematic assessment of the interpretation of figures on health and health care. This study aimed to test and evaluate the FIAT-Health 1.0 amongst its intended user groups, and further refine the tool based on our results.

METHODS

Potential users (N = 32) were asked to assess one publicly reported figure using the FIAT-Health 1.0, and to justify their assessments and share their experience in using the FIAT-Health. In total four figures were assessed. For each figure, an expert on the specific topic (N = 4) provided a comparative assessment. The consistency of the answers was calculated, and answers to the evaluation questions were qualitatively analysed. A qualitative comparative analysis of the justifications for assessment by the experts and potential users was made. Based on the results, a new version of the FIAT-Health was developed and tested by employees (N = 27) of the National Institute for Public Health and the Environment (RIVM), and approved by the project's advisory group. In total sixty-three participants contributed.

RESULTS

Potential users using the FIAT-Health 1.0 and experts gave similar justifications for their assessments. The justifications provided by experts aligned with the items of the FIAT-Health. Seventeen out of twenty-six dichotomous questions were consistently answered by the potential users. Numerical assessment questions showed inconsistencies in how potential users responded. In the evaluation, potential users most frequently mentioned that thanks to its structured approach, the FIAT-Health contributed to their awareness of the main characteristics of the figure (n = 14), but they did find the tool complex (n = 11). The FIAT-Health 1.0 was revised from a scoring instrument into a critical appraisal tool: the FIAT-Health 2.0, which was tested and approved by employees of the RIVM and the advisory group.

CONCLUSION

The tool was refined according to the results of the test and evaluation, transforming the FIAT-Health from a quantitative scoring instrument into an online qualitative appraisal tool that has the potential to aid the better interpretation and public reporting of statistics on health and healthcare.

Differences in Perceptions of Health Information Between the Public and Health Care Professionals: Nonprobability Sampling Questionnaire Survey

Background

In the new media age, the public searches for information both online and offline. Many studies have examined how the public reads and understands this information but very few investigate how people assess the quality of journalistic articles as opposed to information generated by health professionals.

Objective

The aim of this study was to examine how public health care workers (HCWs) and the general public seek, read, and understand health information and to investigate the criteria by which they assess the quality of journalistic articles.

Methods

A Web-based nonprobability sampling questionnaire survey was distributed to Israeli HCWs and members of the public via 3 social media outlets: Facebook, WhatsApp, and Instagram. A total of 979 respondents participated in the online survey via the Qualtrics XM platform.

Results

The findings indicate that HCWs find academic articles more reliable than do members of the general public (44.4% and 28.4%, respectively, P<.001). Within each group, we found disparities between the places where people search for information and the sources they consider reliable. HCWs consider academic articles to be the most reliable, yet these are not their main information sources. In addition, HCWs often use social networks to search for information (18.2%, P<.001), despite considering them very unreliable (only 2.2% found them reliable, P<.001). The same paradoxes were found among the general public, where 37.5% (P<.001) seek information via social networks yet only 8.4% (P<.001) find them reliable. Out of 6 quality criteria, 4 were important both to HCWs and to the general public.

Conclusions

In the new media age where information is accessible to all, the quality of articles about health is of critical importance. It is important that the criteria examined in this research become the norm in health writing for all stakeholders who write about health, whether they are professional journalists or citizen journalists writing in the new media.

Statistics in Dutch policy debates on health and healthcare

Background

The notion of ‘fact-free politics’ is debated in Europe and the United States of America and has particular relevance for the use of evidence to underpin health and healthcare policies. To better understand how evidence on health and healthcare is used in the national policy-making process in the Netherlands, we explore how different statistics are used in various policy debates on health and healthcare in the Dutch government and parliament.

Methods

We chose eight ongoing policy debates as case studies representing the subject categories of morbidity, lifestyle, healthcare expenditure and healthcare outcomes, including (1) breast cancer screening rates, prevalence and incidence, (2) dementia prevalence and incidence, (3) prevalence of alcohol use by pregnant women, (4) mobility and school sports participation in children, (5) costs of smoking, (6) Dutch national healthcare expenditure, (7) hospital mortality rates, and (8) bedsore prevalence. Using selected keywords for each policy debate case, we performed a document search to identify documentation of the debates (2014–2016) on the websites of the Dutch government and parliament. We retrieved 163 documents and examined the policy debate cases through a content analyses approach.

Results

Sources of the statistics used in policy debates were primarily government funded. We identified two distinct functions, i.e. rhetorical and managerial use of statistics. The function of the debate is rhetorical when the specific statistic is used for agenda-setting or to convince the reader of the importance of a topic. The function of the debate is managerial when statistics determine planning, monitoring or evaluation of policy. When evaluating a specific policy, applied statistics were mostly the result of routine or standardised data collection. When policy-makers use statistics for a managerial function, the policy debate mirrors terms derived from scientific debates.

Conclusion

While statistics used for rhetorical functions do not seem to invite critical reflection, when the function of the debate is managerial, i.e. to plan, monitor or evaluate healthcare, their construction does receive attention. Considering the current role of statistics in rhetorical and managerial debates, there is a need to be cautious of too much leniency towards the technocratic process in exchange for the democratic debate.

Electronic supplementary material

The online version of this article (10.1186/s12961-019-0461-y) contains supplementary material, which is available to authorized users.

Improving interpretation of publically reported statistics on health and healthcare: the Figure Interpretation Assessment Tool (FIAT-Health)

BACKGROUND

Policy-makers, managers, scientists, patients and the general public are confronted daily with figures on health and healthcare through public reporting in newspapers, webpages and press releases. However, information on the key characteristics of these figures necessary for their correct interpretation is often not adequately communicated, which can lead to misinterpretation and misinformed decision-making. The objective of this research was to map the key characteristics relevant to the interpretation of figures on health and healthcare, and to develop a Figure Interpretation Assessment Tool-Health (FIAT-Health) through which figures on health and healthcare can be systematically assessed, allowing for a better interpretation of these figures.

METHODS

The abovementioned key characteristics of figures on health and healthcare were identified through systematic expert consultations in the Netherlands on four topic categories of figures, namely morbidity, healthcare expenditure, healthcare outcomes and lifestyle. The identified characteristics were used as a frame for the development of the FIAT-Health. Development of the tool and its content was supported and validated through regular review by a sounding board of potential users.

RESULTS

Identified characteristics relevant for the interpretation of figures in the four categories relate to the figures' origin, credibility, expression, subject matter, population and geographical focus, time period, and underlying data collection methods. The characteristics were translated into a set of 13 dichotomous and 4-point Likert scale questions constituting the FIAT-Health, and two final assessment statements. Users of the FIAT-Health were provided with a summary overview of their answers to support a final assessment of the correctness of a figure and the appropriateness of its reporting.

CONCLUSIONS

FIAT-Health can support policy-makers, managers, scientists, patients and the general public to systematically assess the quality of publicly reported figures on health and healthcare. It also has the potential to support the producers of health and healthcare data in clearly communicating their data to different audiences. Future research should focus on the further validation of the tool in practice.

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.

The Association Between Internet Use and Ambulatory Care-Seeking Behaviors in Taiwan: A Cross-Sectional Study

Background

Compared with the traditional ways of gaining health-related information from newspapers, magazines, radio, and television, the Internet is inexpensive, accessible, and conveys diverse opinions. Several studies on how increasing Internet use affected outpatient clinic visits were inconclusive.

Objective

The objective of this study was to examine the role of Internet use on ambulatory care-seeking behaviors as indicated by the number of outpatient clinic visits after adjusting for confounding variables.

Methods

We conducted this study using a sample randomly selected from the general population in Taiwan. To handle the missing data, we built a multivariate logistic regression model for propensity score matching using age and sex as the independent variables. The questionnaires with no missing data were then included in a multivariate linear regression model for examining the association between Internet use and outpatient clinic visits.

Results

We included a sample of 293 participants who answered the questionnaire with no missing data in the multivariate linear regression model. We found that Internet use was significantly associated with more outpatient clinic visits (P=.04). The participants with chronic diseases tended to make more outpatient clinic visits (P<.01).

Conclusions

The inconsistent quality of health-related information obtained from the Internet may be associated with patients’ increasing need for interpreting and discussing the information with health care professionals, thus resulting in an increasing number of outpatient clinic visits. In addition, the media literacy of Web-based health-related information seekers may also affect their ambulatory care-seeking behaviors, such as outpatient clinic visits.

Academics and competing interests in H1N1 influenza media reporting

BACKGROUND

Concerns have been raised over competing interests (CoI) among academics during the 2009 to 2010 A/H1N1 pandemic. Media reporting can influence public anxiety and demand for pharmaceutical products. We assessed CoI of academics providing media commentary during the early stages of the pandemic.

METHODS

We performed a retrospective content analysis of UK newspaper articles on A/H1N1 influenza, examining quoted sources. We noted when academics made a risk assessment of the pandemic and compared this with official estimations. We also looked for promotion or rejection of the use of neuraminidase inhibitors or H1N1-specific vaccine. We independently searched for CoI for each academic.

RESULTS

Academics were the second most frequently quoted source after Ministers of Health. Where both academics and official agencies estimated the risk of H1N1, one in two academics assessed the risk as higher than official predictions. For academics with CoI, the odds of a higher risk assessment were 5.8 times greater than those made by academics without CoI (Wald p value=0.009). One in two academics commenting on the use of neuraminidase inhibitors or vaccine had CoI. The odds of CoI in academics promoting the use of neuraminidase inhibitors were 8.4 times greater than for academics not commenting on their use (Fisher's exact p=0.005).

CONCLUSIONS

There is evidence of CoI among academics providing media commentary during the early H1N1 pandemic. Heightened risk assessments, combined with advocacy for pharmaceutical products to counter this risk, may lead to increased public anxiety and demand. Academics should declare, and journalists report, relevant CoI for media interviews.

Contemporary neuroscience in the media

Technological innovations in neuroscience have opened new windows to the understanding of brain function and the neuronal underpinnings of brain activity in neuropsychiatric disorders and social behavior. Public interest and support for neuroscience research through initiatives like the Decade of the Brain project and increasingly diverse brain-related initiatives have created new interfaces between neuroscience and society. Against this backdrop of dynamic innovation, we set out to examine how different features of neuroscience are depicted in print media. We used the 'guided news' function of the LexisNexis Academic database with keyword searches to find news articles published between 1995 and 2004 in major U.S. and U.K. English-language news sources. We performed searches on headlines, lead paragraphs, and body terms to maximize search yields. All articles were coded for overall tone of coverage, details on reported studies, presence of ethical, legal, and social discussion as well as the emerging interpretations of neuroscience - in the form of neuro-essentialism, neuro-realism, and neuro-policy. We found that print media coverage of the use of neurotechnology for diagnosis or therapy in neuropsychiatric disorders was generally optimistic. We also found that, even within articles that were identified as research reports, many did not provide details about research studies. We also gained additional insights into the previously identified phenomena of neuro-essentialism, neuro-realism, and neuro-policy showing some profound impacts of neuroscience on personal identity and policy-making. Our results highlight the implications of transfer of neuroscience knowledge to society given the substantial and authoritative weight ascribed to neuroscience knowledge in defining who we are. We also discuss the impact of these findings on neuroscience and on the respective contributions of the social sciences and the biological sciences in contemporary psychiatry and mental health policy.

Reporting science and conflicts of interest in the lay press

BACKGROUND

Forthright reporting of financial ties and conflicts of interest of researchers is associated with public trust in and esteem for the scientific enterprise.

METHODS/PRINCIPAL FINDINGS

We searched Lexis/Nexis Academic News for the top news stories in science published in 2004 and 2005. We conducted a content analysis of 1152 newspaper stories. Funders of the research were identified in 38% of stories, financial ties of the researchers were reported in 11% of stories, and 5% reported financial ties of sources quoted. Of 73 stories not reporting on financial ties, 27% had financial ties publicly disclosed in scholarly journals.

CONCLUSIONS/SIGNIFICANCE

Because science journalists often did not report conflict of interest information, adherence to gold-standard recommendations for science journalism was low. Journalists work under many different constraints, but nonetheless news reports of scientific research were incomplete, potentially eroding public trust in science.

Science communication in transition: genomics hype, public engagement, education and commercialization pressures

This essay reports on the final session of a 2-day workshop entitled 'Genetic Diversity and Science Communication', hosted by the CIHR Institute of Genetics in Toronto, April 2006. The first speaker, Timothy Caulfield, introduced the intersecting communities that promulgate a 'cycle of hype' of the timelines and expected outcomes of the Human Genome Project (HGP): scientists, the media and the public. Other actors also contribute to the overall hype, the social science and humanities communities, industry and politicians. There currently appears to be an abatement of the overblown rhetoric of the HGP. As pointed out by the second speaker, Sharon Kardia, there is broad recognition that most phenotypic traits, including disease susceptibility are multi-factorial. That said, George Davey-Smith reminded us that some direct genotype-phenotype associations may be useful for public health issues. The Mendelian randomization approach hopes to revitalize the discipline of epidemiology by strengthening causal influences about environmentally modifiable risk factors. A more realistic informational environment paves the way for greater public engagement in science policy. Two such initiatives were presented by Kardia and Jason Robert, and Peter Finegold emphasized that science education and professional development for science teachers are important components of later public engagement in science issues. However, pressures on public research institutions to commercialize and seek industry funding may have negative impacts in both encouraging scientists to inappropriately hype research and on diminishing public trust in the scientific enterprise. The latter may have a significant effect on public engagement processes, such as those proposed by Robert and Kardia.

Regulation of clinical research sponsored by pharmaceutical companies: a proposal

Sotelo proposes that a third party, appointed by academic institutions, must be compulsorily placed between clinical researchers and drug companies.

Perspectives on the efficacy of antidepressants for child and adolescent depression

Raz looks at the ongoing controversies surrounding the use of SSRI antidepressants in children.

Why PLoS sponsored a roundtable of medical whistleblowers

On May 15, 2005, PLoS and the Government Accountability Project co-sponsored a roundtable of some of the most high profile medical whistleblowers of recent times.