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Watson S, Benning TJ, Marcon AR, Zhu X, Caulfield T, Sharp RR, Master Z. Descriptions of Scientific Evidence and Uncertainty of Unproven COVID-19 Therapies in US News: Content Analysis Study. JMIR INFODEMIOLOGY 2024; 4:e51328. [PMID: 39207825 PMCID: PMC11393509 DOI: 10.2196/51328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/17/2024] [Accepted: 07/15/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Politicization and misinformation or disinformation of unproven COVID-19 therapies have resulted in communication challenges in presenting science to the public, especially in times of heightened public trepidation and uncertainty. OBJECTIVE This study aims to examine how scientific evidence and uncertainty were portrayed in US news on 3 unproven COVID-19 therapeutics, prior to the development of proven therapeutics and vaccines. METHODS We conducted a media analysis of unproven COVID-19 therapeutics in early 2020. A total of 479 discussions of unproven COVID-19 therapeutics (hydroxychloroquine, remdesivir, and convalescent plasma) in traditional and online US news reports from January 1, 2020, to July 30, 2020, were systematically analyzed for theme, scientific evidence, evidence details and limitations, safety, efficacy, and sources of authority. RESULTS The majority of discussions included scientific evidence (n=322, 67%) although only 24% (n=116) of them mentioned publications. "Government" was the most frequently named source of authority for safety and efficacy claims on remdesivir (n=43, 35%) while "expert" claims were mostly mentioned for convalescent plasma (n=22, 38%). Most claims on hydroxychloroquine (n=236, 79%) were offered by a "prominent person," of which 97% (n=230) were from former US President Trump. Despite the inclusion of scientific evidence, many claims of the safety and efficacy were made by nonexperts. Few news reports expressed scientific uncertainty in discussions of unproven COVID-19 therapeutics as limitations of evidence were infrequently included in the body of news reports (n=125, 26%) and rarely found in headlines (n=2, 2%) or lead paragraphs (n=9, 9%; P<.001). CONCLUSIONS These results highlight that while scientific evidence is discussed relatively frequently in news reports, scientific uncertainty is infrequently reported and rarely found in prominent headlines and lead paragraphs.
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Affiliation(s)
- Sara Watson
- Biomedical Ethics Research Program, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Tyler J Benning
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
| | | | - Xuan Zhu
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States
| | | | - Richard R Sharp
- Biomedical Ethics Research Program, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, United States
| | - Zubin Master
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Maya Angelou Center for Health Equity, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Center for Bioethics, Health and Society, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Wake Forest Institute of Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
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Liu M, Fan X, Ma S. A Linguistic Analysis of News Coverage of E-Healthcare in China with a Heterogeneous Graphical Model. ENTROPY (BASEL, SWITZERLAND) 2022; 24:1557. [PMID: 36359647 PMCID: PMC9689216 DOI: 10.3390/e24111557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
E-healthcare has been envisaged as a major component of the infrastructure of modern healthcare, and has been developing rapidly in China. For healthcare, news media can play an important role in raising public interest and utilization of a particular service and complicating (and, perhaps clouding) debate on public health policy issues. We conducted a linguistic analysis of news reports from January 2015 to June 2021 related to E-healthcare in mainland China, using a heterogeneous graphical modeling approach. This approach can simultaneously cluster the datasets and estimate the conditional dependence relationships of keywords. It was found that there were eight phases of media coverage. The focuses and main topics of media coverage were extracted based on the network hub and module detection. The temporal patterns of media reports were found to be mostly consistent with the policy trend. Specifically, in the policy embryonic period (2015-2016), two phases were obtained, industry management was the main topic, and policy and regulation were the focuses of media coverage. In the policy development period (2017-2019), four phases were discovered. All the four main topics, namely industry development, health care, financial market, and industry management, were present. In 2017 Q3-2017 Q4, the major focuses of media coverage included social security, healthcare and reform, and others. In 2018 Q1, industry regulation and finance became the focuses. In the policy outbreak period (2020-), two phases were discovered. Financial market and industry management were the main topics. Medical insurance and healthcare for the elderly became the focuses. This analysis can offer insights into how the media responds to public policy for E-healthcare, which can be valuable for the government, public health practitioners, health care industry investors, and others.
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Affiliation(s)
- Mengque Liu
- School of Journalism and New Media, Xi’an Jiaotong University, No.28 Xianning West Road, Xi’an 710049, China
| | - Xinyan Fan
- Center for Applied Statistics, School of Statistics, Renmin University of China, 59 Zhongguancun Street, Haidian District, Beijing 100872, China
| | - Shuangge Ma
- Department of Biostatistics, Yale University, 60 College Street, New Haven, CT 06520, USA
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Shi W, Nagler RH, Fowler EF, Gollust SE. Predictors of Women's Awareness of the Benefits and Harms of Mammography Screening and Associations with Confusion, Ambivalence, and Information Seeking. HEALTH COMMUNICATION 2021; 36:303-314. [PMID: 31690128 DOI: 10.1080/10410236.2019.1687129] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
In recent years, there has been a shift toward promoting informed decision making for mammography screening for average-risk women in their 40s. Professional organizations such as the American Cancer Society and U.S. Preventive Services Task Force recommend that women weigh the potential benefits and harms of mammography prior to initiating screening. This decision-making process assumes that women are aware of both the benefits and harms of screening, yet little is known about the prevalence and antecedents of such awareness. Moreover, it is conceivable that women who are aware of both the benefits and harms may interpret this information as conflicting - which could be concerning, as researchers have documented adverse effects of exposure to conflicting health information in prior research. Using data from a population-based survey of U.S. women aged 30-59 (N = 557), the current study found that awareness of mammography's harms is relatively low compared to awareness of benefits. Health news exposure and interpersonal communication about health were associated with greater awareness of harms. In addition, women's awareness of both the benefits and harms was positively associated with confusion about breast cancer screening recommendations, ambivalence about getting a mammogram, and mammogram-related information seeking from online sources. Implications for cancer screening communication are discussed.
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Affiliation(s)
- Weijia Shi
- Hubbard School of Journalism and Mass Communication, University of Minnesota
| | - Rebekah H Nagler
- Hubbard School of Journalism and Mass Communication, University of Minnesota
| | | | - Sarah E Gollust
- Division of Health Policy and Management, University of Minnesota School of Public Health
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4
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Abstract
Governments and financial institutions in several jurisdictions are planning or implementing nonmedical/'forced' switches by cutting drug coverage for reference biologics and funding only less expensive biosimilars. Switches raise numerous ethical and legal challenges, as the drugs are framed as not being identical and, despite strong evidence for noninferiority of some biosimilars, there is controversy over whether switching can sometimes lead to adverse events. Canadian law generally requires physicians to give precedence to their patients' best interests over social interests such as cost containment. The primacy of patients' interests is also clearly reflected in professional policies and codes of ethics. Moreover, physicians are obligated to disclose everything a reasonable person in the patient's position would want to know when obtaining informed consent for treatment, including addressing not only scientific information but also relevant social controversy about nonmedical switches. Under Canadian law, physicians may be obligated to tell patients about the ability to access unfunded biologics, even if patients lack the resources to obtain them. In sum, while there is no inherent right to funding for reference biologics in Canada, physicians in some circumstances may have a legal obligation as fiduciaries to advocate on behalf of patients to remain on a reference biologic. At a minimum, the controversy surrounding switching will necessitate, as part of the consent process, a robust and thorough disclosure of relevant risks, benefits and reasonable alternatives.
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Affiliation(s)
- Blake Murdoch
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, Canada
| | - Timothy Caulfield
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, Canada
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5
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Nagler RH, Fowler EF, Marino NM, Mentzer KM, Gollust SE. The Evolution of Mammography Controversy in the News Media: A Content Analysis of Four Publicized Screening Recommendations, 2009 to 2016. Womens Health Issues 2018; 29:87-95. [PMID: 30409689 DOI: 10.1016/j.whi.2018.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 09/17/2018] [Accepted: 09/20/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND There is longstanding expert disagreement about the age at and frequency with which women should be screened for breast cancer. These debates are reflected in the conflicting recommendations about mammography issued by major professional organizations, such as the U.S. Preventive Services Task Force and the American Cancer Society. Previous research has shown that these recommendations garner substantial media attention-and therefore might affect women's screening perceptions and behaviors-but to date analyses of such media coverage have focused on single publicized announcements. METHODS To assess whether media coverage of mammography screening recommendations has evolved, we conducted a content analysis of televised news from four discrete media events from 2009 to 2016, all of which focused on publicized screening recommendations from the U.S. Preventive Services Task Force and American Cancer Society (N = 364 stories). RESULTS Media coverage of mammography screening recommendations has featured persistent messages of conflict and/or controversy over time. The evolution of controversy was also reflected in shifts in the relative attention given to mammography screening's risks and benefits, with consistent and, in some cases, heightened attention to screening's risks during more recent media events. Overall, the accuracy of media coverage improved over time. CONCLUSIONS Results underscore the continued prevalence of conflicting and/or controversial information about mammography screening in the public information environment. Cumulative exposure to such messages could influence women's decision making around screening and trust in cancer prevention recommendations. Strategies are needed to better equip all women (and particularly underserved women) to negotiate mammography controversy and weigh the benefits and risks of screening.
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Affiliation(s)
- Rebekah H Nagler
- Hubbard School of Journalism & Mass Communication, University of Minnesota, Minneapolis, Minnesota.
| | | | - Nora M Marino
- Interdisciplinary Research Leaders Program, Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Kari McClure Mentzer
- Division of Health Policy & Management, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Sarah E Gollust
- Division of Health Policy & Management, University of Minnesota School of Public Health, Minneapolis, Minnesota
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Marcon AR, Bieber M, Caulfield T. Representing a "revolution": how the popular press has portrayed personalized medicine. Genet Med 2018; 20:950-956. [PMID: 29300377 DOI: 10.1038/gim.2017.217] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/26/2017] [Indexed: 12/16/2022] Open
Abstract
PURPOSE This study investigated the portrayal of "personalized" and "precision" medicine (PM) in North American news over the past decade. Content analysis of print and online news was conducted to determine how PM has been defined and to identify the frames used to discuss PM, including associated topics, benefits, and concerns. METHODS A data set was built using the FACTIVA database, searching for popular North American publications with the terms "personalized (personalised) medicine" and/or "precision medicine" from 1 January 2005 to 15 March 2016. The final set of publications totaled 774. RESULTS PM is almost exclusively defined as related to genetics and is often part of a story related to cancer. The PM story is overwhelmingly one of highlighting (potential) benefits and optimism, especially in shorter publications, and ones where PM is not the main focus. This promotional PM discourse has remained fairly consistent over the past decade. CONCLUSION The numerous concerns associated with PM have received little attention over the past decade, especially in articles more likely to be encountered by a more general audience. This promotion of PM serves as an example of the science hyping that takes place in science reportage and may have implications for consumers, public expectations, and related health policy.
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Affiliation(s)
- Alessandro R Marcon
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, Canada
| | - Mark Bieber
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Timothy Caulfield
- Health Law Institute, Faculty of Law, University of Alberta, Edmonton, Alberta, Canada. .,Faculty of Law and School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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7
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Dempster G. The communication of health information through the media: public health opportunity. Aust N Z J Public Health 2017; 41:541. [DOI: 10.1111/1753-6405.12672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Georgia Dempster
- The Melbourne School of Population and Global Health; The University of Melbourne; Victoria
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8
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Eliott J, Forster AJ, McDonough J, Bowd K, Crabb S. An examination of Australian newspaper coverage of the link between alcohol and cancer 2005 to 2013. BMC Public Health 2017; 18:47. [PMID: 28738890 PMCID: PMC5525277 DOI: 10.1186/s12889-017-4569-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 07/05/2017] [Indexed: 11/15/2022] Open
Abstract
Background Alcohol is a Class-1 carcinogen but public awareness of the link between alcohol and cancer is low. The news media is a popular, readily-accessible source of health information and plays a key role in shaping public opinion and influencing policy-makers. Examination of how the link between alcohol and cancer is presented in Australian print media could inform public health advocacy efforts to raise awareness of this modifiable cancer risk factor. Method This study provides a summative qualitative content analysis of 1502 articles that included information about a link between alcohol and cancer, as reported within Australian newspaper media (2005–2013). We use descriptive statistics to examine the prominence of reports, the nature and content of claims regarding the link between alcohol and cancer, and the source of information noted in each article. Results Articles were distributed throughout newspapers, most appearing within the main (first) section. The link between alcohol and cancer tended not to appear early in articles, and rarely featured in headlines. 95% of articles included a claim that alcohol causes cancer, 5% that alcohol prevented or did not cause cancer, 1% included both. Generally, the amount of alcohol that would cause or prevent cancer was unspecified or open to subjective interpretation. Coverage increased over time, primarily within community/free papers. The claim that alcohol causes cancer often named a specific cancer, did not name a specific alcohol, was infrequently the focus of articles (typically subsumed within an article on general health issues), and cited various health-promoting (including advocacy) organisations as information sources. Articles that included the converse also tended not to focus on that point, often named a specific type of alcohol, and most cited research institutions or generic ‘research’ as sources. Half of all articles involved repetition of materials, and most confirmed that alcohol caused cancer. Conclusions Information about a link between alcohol and cancer is available in the Australian newsprint media, but may be hidden within and thus overshadowed by other health-related stories. Strategic collaboration between health promoting organisations, and exploitation of ‘churnalism’ and journalists’ preferences for ready-made ‘copy’ may facilitate increased presence and accuracy of the alcohol-cancer message.
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Affiliation(s)
- Jaklin Eliott
- The University of Adelaide, Adelaide, South Australia, 5005, Australia.
| | | | - Joshua McDonough
- The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Kathryn Bowd
- The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Shona Crabb
- The University of Adelaide, Adelaide, South Australia, 5005, Australia
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9
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Media reporting of ProtecT: a disconnect in information dissemination? Prostate Cancer Prostatic Dis 2017; 20:401-406. [DOI: 10.1038/pcan.2017.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 03/21/2017] [Accepted: 03/30/2017] [Indexed: 11/09/2022]
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10
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Nicholls R, Perry L, Gallagher R, Duffield C, Sibbritt D, Xu X. The personal cancer screening behaviours of nurses and midwives. J Adv Nurs 2017; 73:1403-1420. [DOI: 10.1111/jan.13221] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2016] [Indexed: 12/14/2022]
Affiliation(s)
- Rachel Nicholls
- Faculty of Health University of Technology Sydney New South Wales Australia
| | - Lin Perry
- Faculty of Health University of Technology Sydney New South Wales Australia
| | - Robyn Gallagher
- Charles Perkins Centre Sydney Nursing School University of Sydney New South Wales Australia
| | - Christine Duffield
- Centre for Health Services Management Faculty of Health University of Technology Sydney New South Wales Australia
- Edith Cowan University Perth Western Australia Australia
| | - David Sibbritt
- Faculty of Health University of Technology Sydney New South Wales Australia
| | - Xiaoyue Xu
- Faculty of Health and Medicine University of Newcastle New South Wales Australia
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Pickles K, Carter SM, Rychetnik L, Entwistle VA. Doctors' perspectives on PSA testing illuminate established differences in prostate cancer screening rates between Australia and the UK: a qualitative study. BMJ Open 2016; 6:e011932. [PMID: 27920082 PMCID: PMC5168698 DOI: 10.1136/bmjopen-2016-011932] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To examine how general practitioners (GPs) in the UK and GPs in Australia explain their prostate-specific antigen (PSA) testing practices and to illuminate how these explanations are similar and how they are different. DESIGN A grounded theory study. SETTING Primary care practices in Australia and the UK. PARTICIPANTS 69 GPs in Australia (n=40) and the UK (n=29). We included GPs of varying ages, sex, clinical experience and patient populations. All GPs interested in participating in the study were included. RESULTS GPs' accounts revealed fundamental differences in whether and how prostate cancer screening occurred in their practice and in the broader context within which they operate. The history of prostate screening policy, organisational structures and funding models appeared to drive more prostate screening in Australia and less in the UK. In Australia, screening processes and decisions were mostly at the discretion of individual clinicians, and varied considerably, whereas the accounts of UK GPs clearly reflected a consistent, organisationally embedded approach based on local evidence-based recommendations to discourage screening. CONCLUSIONS The GP accounts suggested that healthcare systems, including historical and current organisational and funding structures and rules, collectively contribute to how and why clinicians use the PSA test and play a significant role in creating the mindlines that GPs employ in their clinic. Australia's recently released consensus guidelines may support more streamlined and consistent care. However, if GP mindlines and thus routine practice in Australia are to shift, to ultimately reduce unnecessary or harmful prostate screening, it is likely that other important drivers at all levels of the screening process will need to be addressed.
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Affiliation(s)
- Kristen Pickles
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Stacy M Carter
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - Lucie Rychetnik
- School of Medicine, University of Notre Dame, Sydney, New South Wales, Australia
| | - Vikki A Entwistle
- Health Services Research Unit, University of Aberdeen, Foresterhill Aberdeen, UK
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12
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Du L, Rachul C, Guo Z, Caulfield T. Gordie Howe's "Miraculous Treatment": Case Study of Twitter Users' Reactions to a Sport Celebrity's Stem Cell Treatment. JMIR Public Health Surveill 2016; 2:e8. [PMID: 27227162 PMCID: PMC4869214 DOI: 10.2196/publichealth.5264] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/20/2015] [Accepted: 01/04/2016] [Indexed: 01/24/2023] Open
Abstract
Background Former Detroit Red Wing Gordie Howe received stem cell (SC) treatment in Mexico in December 2014 for a stroke he suffered in October 2014. The news about his positive response to the SC treatment prompted discussion on social networks like Twitter. Objective This study aims to provide information about discussions that took place on Twitter regarding Howe’s SC treatment and SC treatment in general. In particular, this study examines whether tweets portrayed a positive or negative attitude towards Howe’s SC treatment, whether or not tweets mention that the treatment is unproven, and whether the tweets mention risks associated with the SC treatment. Methods This is an infodemiology study, harnessing big data published on the Internet for public health research and analysis of public engagement. A corpus of 2783 tweets about Howe’s SC treatment was compiled using a program that collected English-language tweets from December 19, 2014 at 00:00 to February 7, 2015 at 00:00. A content analysis of the corpus was conducted using a coding framework developed through a two-stage process. Results 78.87% (2195/2783) of tweets mentioned improvements to Howe’s health. Only one tweet explicitly mentioned that Howe’s SC treatment was unproven, and 3 tweets warned that direct-to-consumer SC treatments lacked scientific evidence. In addition, 10.31% (287/2783) of tweets mentioned challenges with SC treatment that have been raised by scientists and researchers, and 3.70% (103/2783) of tweets either defined Howe as a “stem cell tourist” or claimed that his treatment was part of “stem cell tourism”. In general, 71.79% (1998/2783) of tweets portrayed a positive attitude towards Howe’s SC treatment. Conclusions Our study found the responses to Howe’s treatment on Twitter to be overwhelmingly positive. There was far less attention paid to the lack of scientific evidence regarding the efficacy of the treatment. Unbalanced and uncritical discussion on Twitter regarding SC treatments is another example of inaccurate representations of SC treatments that may create unrealistic expectations that will facilitate the market for unproven stem cell therapies.
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Affiliation(s)
- Li Du
- Health Law Institute Faculty of Law University of Alberta Edmonton, AB Canada
| | - Christen Rachul
- School of Linguistics and Language Studies Carleton University Ottawa, ON Canada
| | - Zhaochen Guo
- Department of Computing Science University of Alberta Edmonton, AB Canada
| | - Timothy Caulfield
- Health Law Institute, Law Centre, University of Alberta Edmonton, AB Canada
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Chae J, Lee CJ, Jensen JD. Correlates of Cancer Information Overload: Focusing on Individual Ability and Motivation. HEALTH COMMUNICATION 2015; 31:626-34. [PMID: 26512760 DOI: 10.1080/10410236.2014.986026] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The present study defined cancer information overload (CIO) as an aversive disposition wherein a person is confused and overwhelmed by cancer information, which occurs when he or she fails to effectively categorize new information due to a lack of resources for effective learning. Based on the definition and informed by previous studies on information overload and the cognitive mediation model, we hypothesized that low ability and motivation to process cancer information would lead to CIO. We used education level and trait anxiety as factors related to ability. Cancer history and the use of active media channels (such as the Internet and print media) were adopted as motivational factors. Four samples (three from the United States and one from South Korea) were used to explore the relationship between ability/motivation and CIO. Among them, only Sample 4 participants answered questions about stomach cancer, and other participants were asked about cancer in general. In all four samples, trait anxiety was positively associated with CIO. Health information use from active media channels (print or the Internet) was negatively associated with CIO in three samples. The associations between family history and CIO, and between education and CIO, were found in two samples. In short, the present study demonstrated that CIO partly depends on individual ability and motivation, thereby showing that CIO is influenced by personal characteristics as well as environmental factors.
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Affiliation(s)
- Jiyoung Chae
- a Department of Communications and New Media , National University of Singapore
| | - Chul-joo Lee
- b Department of Communication , Seoul National University
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14
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Rachul C, Caulfield T. The media and access issues: content analysis of Canadian newspaper coverage of health policy decisions. Orphanet J Rare Dis 2015; 10:102. [PMID: 26303029 PMCID: PMC4548449 DOI: 10.1186/s13023-015-0320-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 08/10/2015] [Indexed: 11/25/2022] Open
Abstract
Background Previous studies have demonstrated how the media has an influence on policy decisions and healthcare coverage. Studies of Canadian media have shown that news coverage often emphasizes and hypes certain aspects of high profile health debates. We hypothesized that in Canadian media coverage of access to healthcare issues about therapies and technologies including for rare diseases, the media would be largely sympathetic towards patients, thus adding to public debate that largely favors increased access to healthcare—even in the face of equivocal evidence regarding efficacy. Methods In order to test this hypothesis, we conducted a content analysis of 530 news articles about access to health therapies and technologies from 15 major Canadian newspapers over a 10-year period. Articles were analyzed for the perspectives presented in the articles and the types of reasons or arguments presented either for or against the particular access issue portrayed in the news articles. Results We found that news media coverage was largely sympathetic towards increasing healthcare funding and ease of access to healthcare (77.4 %). Rare diseases and orphan drugs were the most common issues raised (22.6 %). Patients perspectives were often highlighted in articles (42.3 %). 96.8 % of articles discussed why access to healthcare needs to increase, and discussion that questioned increased access was only included in 33.6 % articles. Conclusion We found that news media favors a patient access ethos, which may contribute to a difficult policy-making environment.
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Affiliation(s)
- Christen Rachul
- School of Linguistics and Language Studies, Carleton University, Paterson Hall 236, 1125 Colonel By Drive, Ottawa, ON, K1S 5B6, Canada.
| | - Timothy Caulfield
- Faculty of Law and School of Public Health, Health Law Institute, University of Alberta, Office 468, Edmonton, AB, T6G 2H5, Canada.
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15
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Gordie Howe’s Stem Cell ‘Miracle’: A Qualitative Analysis of News Coverage and Readers’ Comments in Newspapers and Sports Websites. Stem Cell Rev Rep 2015; 11:667-75. [DOI: 10.1007/s12015-015-9606-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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16
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Gorday W, Sadrzadeh H, de Koning L, Naugler C. Association of sociodemographic factors and prostate-specific antigen (PSA) testing. Clin Biochem 2014; 47:164-9. [PMID: 25130956 DOI: 10.1016/j.clinbiochem.2014.08.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/30/2014] [Accepted: 08/01/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVES There are conflicting recommendations regarding the use of prostate specific antigen (PSA) as a screening test. Integral to this debate is an understanding of who is currently being tested. The purpose of this study was to provide a detailed account of PSA testing practices in a major Canadian city (Calgary, Alberta) and to identify variables that may affect access to the PSA test. DESIGN AND METHODS PSA test counts were retrieved from Calgary Laboratory Services' Laboratory Information System from January 1, 2011 to December 31, 2011. A total of 75,914 individual PSA tests were included in our analysis. The frequency of PSA testing was plotted onto a dissemination area map of Calgary using ArcGIS software. Associations with sociodemographic variables were tested using Poisson regression. RESULTS The median PSA value was 0.93 μg/L and the median age at collection was 58 years. Forty-three percent of men aged 60-69 received a PSA test. Visible minority status 'Black' (P=0.0002) and Métis status (P=0.0075) were associated with lower PSA testing frequencies, while median household income (P=<0.0001) and university education (P=<0.0001) were associated with higher PSA testing frequencies. CONCLUSION There are areas in Calgary which are significantly over or under tested relative to the mean. The amount of PSA testing in men <50 years of age is increasing, which is contrary to PSA testing guidelines.
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Affiliation(s)
- William Gorday
- Calgary Laboratory Services, Calgary, Alberta, Canada; Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Hossein Sadrzadeh
- Calgary Laboratory Services, Calgary, Alberta, Canada; Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Lawrence de Koning
- Calgary Laboratory Services, Calgary, Alberta, Canada; Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Christopher Naugler
- Calgary Laboratory Services, Calgary, Alberta, Canada; Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada.
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Elstad EA, Sheridan SL, Lee JGL, Rini C, Earp JA, Brewer NT. Have screening harms become newsworthy? News coverage of prostate and colorectal cancer screening since the 2008 USPSTF recommendation changes. J Behav Med 2014; 37:1242-51. [DOI: 10.1007/s10865-014-9572-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 05/14/2014] [Indexed: 12/24/2022]
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Rychetnik L, Carter SM, Barratt A, Irwig L. Expanding the evidence on cancer screening: the value of scientific, social and ethical perspectives. Med J Aust 2013; 198:536-9. [PMID: 23725267 DOI: 10.5694/mja12.11275] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We propose an expanded approach to evidence for cancer screening policy and practice. First, we need to better understand why and how screening happens the way it does, sometimes at odds with evidence of benefits and harms. Second, we need to systematically investigate the ethics of cancer screening to illuminate moral concerns and expand the scope of screening research to address ethical dilemmas. An expanded approach will offer essential information to better support well reasoned judgements, and develop more accountable and less contested cancer screening policies.
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Ilic D, Murphy K, Green S. Perspectives on knowledge, information seeking and decision-making behaviour about prostate cancer among Australian men. JOURNAL OF MEN'S HEALTH 2013. [DOI: 10.1016/j.jomh.2012.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Wilson AJ, Robertson J, Ewald BD, Henry D. What the public learns about screening and diagnostic tests through the media. Med J Aust 2012; 197:324-6. [DOI: 10.5694/mja11.11504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - David Henry
- Institute of Clinical Evaluative Sciences, Toronto, Ontario, Canada
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Gardiner RA, Yaxley J, Coughlin G, Dunglison N, Occhipinti S, Younie S, Carter R, Williams S, Medcraft RJ, Bennett N, Lavin MF, Chambers SK. A randomised trial of robotic and open prostatectomy in men with localised prostate cancer. BMC Cancer 2012; 12:189. [PMID: 22632109 PMCID: PMC3515414 DOI: 10.1186/1471-2407-12-189] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 05/15/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prostate cancer is the most common male cancer in the Western world however there is ongoing debate about the optimal treatment strategy for localised disease. While surgery remains the most commonly received treatment for localised disease in Australia more recently a robotic approach has emerged as an alternative to open and laparoscopic surgery. However, high level data is not yet available to support this as a superior approach or to guide treatment decision making between the alternatives. This paper presents the design of a randomised trial of Robotic and Open Prostatectomy for men newly diagnosed with localised prostate cancer that seeks to answer this question. METHODS/DESIGN 200 men per treatment arm (400 men in total) are being recruited after diagnosis and before treatment through a major public hospital outpatient clinic and randomised to 1) Robotic Prostatectomy or 2) Open Prostatectomy. All robotic prostatectomies are being performed by one surgeon and all open prostatectomies are being performed by one other surgeon. Outcomes are being measured pre-operatively and at 6 weeks and 3, 6, 12 and 24 months post-surgery. Oncological outcomes are being related to positive surgical margins, biochemical recurrence +/- the need for further treatment. Non-oncological outcome measures include: pain, physical and mental functioning, fatigue, summary (preference-based utility scores) and domain-specific QoL (urinary incontinence, bowel function and erectile function), cancer specific distress, psychological distress, decision-related distress and time to return to usual activities. Cost modelling of each approach, as well as full economic appraisal, is also being undertaken. DISCUSSION The study will provide recommendations about the relative benefits of Robotic and Open Prostatectomy to support informed patient decision making about treatment for localised prostate cancer; and to assist in treatment services planning for this patient group. TRIAL REGISTRATION ACTRN12611000661976.
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Affiliation(s)
- Robert A Gardiner
- University of Queensland Centre for Clinical Research, Royal Brisbane Hospital, Queensland, Australia
- Department of Urology, Royal Brisbane Hospital, Queensland, Australia
- Edith Cowan University Health and Wellness Institute, Edith Cowan University, Western Australia, Australia
| | - John Yaxley
- Department of Urology, Royal Brisbane Hospital, Queensland, Australia
| | - Geoff Coughlin
- Department of Urology, Royal Brisbane Hospital, Queensland, Australia
| | - Nigel Dunglison
- Department of Urology, Royal Brisbane Hospital, Queensland, Australia
| | - Stefano Occhipinti
- Griffith Health Institute, Griffith University, Queensland Victoria,, Australia
| | - Sandra Younie
- Deakin Health Economics, Deakin University, Victoria, Australia
| | - Rob Carter
- Deakin Health Economics, Deakin University, Victoria, Australia
| | | | - Robyn J Medcraft
- University of Queensland Centre for Clinical Research, Royal Brisbane Hospital, Queensland, Australia
- Department of Urology, Royal Brisbane Hospital, Queensland, Australia
| | - Nigel Bennett
- University of Queensland Centre for Clinical Research, Royal Brisbane Hospital, Queensland, Australia
| | - Martin F Lavin
- University of Queensland Centre for Clinical Research, Royal Brisbane Hospital, Queensland, Australia
- Radiation Biology and Oncology Laboratory, Queensland Institute of Medical Research, Victoria, Australia
| | - Suzanne Kathleen Chambers
- University of Queensland Centre for Clinical Research, Royal Brisbane Hospital, Queensland, Australia
- Edith Cowan University Health and Wellness Institute, Edith Cowan University, Western Australia, Australia
- Griffith Health Institute, Griffith University, Queensland Victoria,, Australia
- Cancer Council Queensland, Queensland, Australia
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Bynum SA, Malo TL, Lee JH, Guiliano AR, Vadaparampil ST. HPV vaccine information-seeking behaviors among US physicians: government, media, or colleagues? Vaccine 2011; 29:5090-3. [PMID: 21619906 DOI: 10.1016/j.vaccine.2011.04.134] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 04/13/2011] [Accepted: 04/27/2011] [Indexed: 10/18/2022]
Abstract
The multiple information sources available may pose a challenge to physicians in providing accurate human papillomavirus (HPV) vaccine information to patients. The purpose of this study was to describe physicians' HPV vaccine information-seeking behaviors and assess if these behaviors differ by physician specialty and sociodemographic characteristics. In 2009, 1008 Family Physicians (FPs), Pediatricians (Peds), and Obstetricians/Gynecologists (OBGYNs) completed a survey to assess their HPV vaccine information-seeking behaviors and vaccination practices. The largest proportion obtained HPV vaccine information from professional organizations (50.0%), followed by the Advisory Council on Immunization Practices (ACIP) (36.0%), and medical conferences (33.1%). Peds and FPs were more likely to obtain vaccine information from the ACIP (p-values<0.05). OBGYNs, non-White/Caucasian physicians, and those aged 40-49 were more likely to obtain vaccine information from internet websites (p-values<0.05). There is a need for targeted HPV vaccine communication approaches based on sociodemographic and physician specialty characteristics.
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Affiliation(s)
- Shalanda A Bynum
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL 33612-9416, USA.
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Abstract
While some media reports offer accurate interpretations of clinical research, other reports are misleading. The uneven accuracy of medical reporting may act in concert with its sheer volume to confuse the lay public about which health messages are most important and evidence-based. I outline one possible step towards a solution: medical journals can embed quality of evidence ratings in article summaries and create incentives for inclusion of these ratings in lay media reports.
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Latronico N, Manenti O, Baini L, Rasulo FA. Quality of reporting on the vegetative state in Italian newspapers. The case of Eluana Englaro. PLoS One 2011; 6:e18706. [PMID: 21533275 PMCID: PMC3075268 DOI: 10.1371/journal.pone.0018706] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Accepted: 03/16/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Media coverage of the vegetative state (VS) includes refutations of the VS diagnosis and describes behaviors inconsistent with VS. We used a quality score to assess the reporting in articles describing the medical characteristics of VS in Italian newspapers. METHODOLOGY/PRINCIPAL FINDINGS Our search covered a 7-month period from July 1, 2008, to February 28, 2009, using the online searchable databases of four major Italian newspapers: Corriere della Sera, La Repubblica, La Stampa, and Avvenire. Medical reporting was judged as complete if three core VS characteristics were described: patient unawareness of self and the environment, preserved wakefulness (eyes open), and spontaneous respiration (artificial ventilator not needed). We retrieved 2,099 articles, and 967 were dedicated to VS. Of these, 853 (88.2%) were non-medical and mainly focused on describing the political, legal, and ethical aspects of VS. Of the 114 (11.8%) medical articles, 53 (5.5%) discussed other medical problems such as death by dehydration, artificial nutrition, neuroimaging, brain death, or uterine hemorrhage, and 61 (6.3%) described VS. Of these 61, only 18 (1.9%) reported all three CORE characteristics and were judged complete. We found no differences among the four investigated newspapers (Fisher's exact = 0.798), and incomplete articles were equally distributed between journalistic pieces and expert opinions (χ(2) = 1.8854, P = 0.170). Incorrect descriptions of VS were significantly more common among incomplete articles (13 of 43 vs. 1 of 18; Fisher's exact P = 0.047). CONCLUSIONS/SIGNIFICANCE Core VS characteristics are rarely reported in Italian newspaper articles, which can alter adequate comprehension of new developments and (mis)inform political, legal, and ethical decisions.
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Affiliation(s)
- Nicola Latronico
- Department of Neuroanesthesia and Neurointensive Care, University of Brescia, Spedali Civili, Brescia, Italy.
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Lawrentschuk N, Daljeet N, Trottier G, Crawley P, Fleshner NE. An analysis of world media reporting of two recent large randomized prospective trials investigating screening for prostate cancer. BJU Int 2011; 108:E190-5. [DOI: 10.1111/j.1464-410x.2010.09983.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Langbecker D, Youl P, Kimlin M, Remm K, Janda M. Factors associated with recall of media reports about vitamin D and sun protection. Aust N Z J Public Health 2011; 35:159-62. [DOI: 10.1111/j.1753-6405.2011.00686.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wilson AJ, Bonevski B, L Jones A, A Henry D. Deconstructing cancer: what makes a good‐quality news story? Med J Aust 2010; 193:702-6. [DOI: 10.5694/j.1326-5377.2010.tb04109.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Accepted: 10/07/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Amanda J Wilson
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW
| | - Billie Bonevski
- Centre for Health Research and Psycho‐oncology, University of Newcastle, Newcastle, NSW
- Cancer Council New South Wales, Sydney, NSW
| | | | - David A Henry
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
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Hoffman RM, Lewis CL, Pignone MP, Couper MP, Barry MJ, Elmore JG, Levin CA, Van Hoewyk J, Zikmund-Fisher BJ. Decision-making processes for breast, colorectal, and prostate cancer screening: the DECISIONS survey. Med Decis Making 2010; 30:53S-64S. [PMID: 20881154 PMCID: PMC3139436 DOI: 10.1177/0272989x10378701] [Citation(s) in RCA: 140] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients should understand the risks and benefits of cancer screening in order to make informed screening decisions. OBJECTIVES To evaluate the extent of informed decision making in patient-provider discussions for colorectal (CRC), breast (BrCa), and prostate (PCa) cancer screening. SETTING National sample of US adults identified by random-digit dialing. DESIGN Cross-sectional survey conducted between November 2006 and May 2007. PARTICIPANTS English-speaking US adults aged 50 y and older who had discussed cancer screening with a health care provider within the previous 2 y. MEASUREMENTS Cancer screening survey modules that asked about demographic characteristics, cancer knowledge, the importance of various sources of information, and self-reported cancer screening decision-making processes. RESULTS Overall, 1082 participants completed 1 or more of the 3 cancer modules. Although participants generally considered themselves well informed about screening tests, half or more could not correctly answer even 1 open-ended knowledge question for any given module. Participants consistently overestimated risks for being diagnosed with and dying from each cancer and overestimated the positive predictive values of prostate-specific antigen tests and mammography. Providers were the most highly rated information source, usually initiated screening discussions (64%-84%), and often recommended screening (73%-90%). However, participants reported that providers elicited their screening preferences in only 31% (CRC women) to 57% (PCa) of discussions. Although more than 90% of the discussions addressed the pros of screening, only 19% (BrCa) to 30% (PCa) addressed the cons of screening. LIMITATIONS Recall bias is possible because screening process reports were not independently validated. CONCLUSIONS Cancer screening decisions reported by patients who discussed screening with their health care providers consistently failed to meet criteria for being informed. Given the high ratings for provider information and frequent recommendations for screening, providers have important opportunities to ensure that informed decision making occurs for cancer screening decisions.
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Affiliation(s)
- Richard M Hoffman
- Medicine Service, New Mexico VA Health Care System and Department of Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA.
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Kemp GA, Eagle L, Verne J. Mass media barriers to social marketing interventions: the example of sun protection in the UK. Health Promot Int 2010; 26:37-45. [PMID: 20713412 DOI: 10.1093/heapro/daq048] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The role of the mass media in communicating health-related information to the wider population is the focus of this paper. Using the example of sun protection within the UK, we highlight some of the major challenges to raising awareness of steadily increasing melanoma rates and of effective sun protection strategies. The implications of potential barriers to official sun protection messages via conflicting messages in the media are discussed in terms of editorial on sun protection and in the way in which television programme content portrays the issues. Implications for public policy and future research conclude the paper.
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Affiliation(s)
- Gillian Ann Kemp
- University of the West of England, Coldharbour Road, Frenchay, Bristol, Bristol BS16 1QY, UK.
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MacKenzie R, Chapman S, McGeechan K, Holding S. 'A disease many people still feel uncomfortable talking about': Australian television coverage of colorectal cancer. Psychooncology 2010; 19:283-8. [PMID: 19382099 DOI: 10.1002/pon.1567] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To examine the coverage of colorectal cancer on Australian television news over a 3 year period commencing May 2005, and compare it with that given to other cancers. METHODS News reports on colorectal cancer broadcast on Sydney's five free-to-air television channels between 3 May 2005 and 30 May 2008 were reviewed for statements by news actors. The frequency of coverage was compared with that for other cancers. RESULTS Colorectal cancer news reports accounted for 4.1% (95% CI 2.9-5.1%) of all cancer news reports while the cancer represents 13.5% of cancer incidence and 11.5% of cancer deaths. Compared to cancers receiving greater television news coverage, there was a near total absence of reports of celebrity diagnoses, and of representations by colorectal advocacy groups. A national colorectal screening programme received limited coverage. CONCLUSIONS Media neglect of colorectal cancer may be an important factor in explaining low participation in the Australian colorectal screening programme. Those advocating for colorectal cancer screening face ingrained cultural challenges in gaining broad media coverage, but investment in efforts to generate news and commentary would appear to be overdue.
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Affiliation(s)
- Ross MacKenzie
- School of Public Health, University of Sydney, Sydney, Australia
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Denham JW, Bender R, Paradice WEJ. It's time to depolarise the unhelpful PSA-testing debate and put into practice lessons from the two major international screening trials. Med J Aust 2010; 192:393-6. [PMID: 20367587 DOI: 10.5694/j.1326-5377.2010.tb03562.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Accepted: 11/10/2009] [Indexed: 11/17/2022]
Abstract
Two recently reported large-scale trials conducted in the United States and western Europe have provided evidence that coordinated screening programs will not reduce mortality in countries or regions where prostate-specific antigen (PSA) testing is already highly prevalent, but will reduce mortality in places where PSA testing prevalence is low. The trials also produce evidence that coordinated screening will cause over-diagnosis and over-treatment. The instigation of a national screening program should be delayed until a more specific marker for aggressive disease than PSA level becomes available. In the meantime, results of the two trials can be used to inform the development of regional testing policies in Australia. These policies should encourage regular PSA testing in regions with low testing prevalence, but must also embrace methods of dealing with over-diagnosis and over-treatment. "Active surveillance" programs (whereby men with early-stage cancers are monitored regularly by PSA testing and digital rectal examinations) and development of counselling services should be encouraged.
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Affiliation(s)
- James W Denham
- Prostate Cancer Trials Group, University of Newcastle, Newcastle, NSW, Australia.
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Mercurio R, Eliott JA. Trick or treat? Australian newspaper portrayal of complementary and alternative medicine for the treatment of cancer. Support Care Cancer 2009; 19:67-80. [PMID: 19943067 DOI: 10.1007/s00520-009-0790-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Accepted: 11/11/2009] [Indexed: 11/29/2022]
Abstract
PURPOSE Many cancer patients within developed nations cite the media as informing their decisions to use complementary and alternative medicine (CAM). The present study describes (1) Australian newspaper coverage of CAM use for cancer between 1998 and 2007; (2) trends in reporting frequency and characteristics; and (3) how the Australian press framed stories on CAM use for cancer. MATERIALS AND METHODS This study is a content analysis featuring quantitative and qualitative techniques, the latter guided by 'media framing', of targeted newspaper articles. RESULTS One hundred nineteen articles focused on CAM use for the treatment of cancer were identified. Quantitative analysis found that biologically based CAMs were most frequently described and breast cancer most mentioned. Two thirds of all articles described CAM use in the context of a cure, with approximately half of these opposing this reason for use. Potential benefits of CAM were discussed more frequently than potential risks, and information on costs and how to access CAM were uncommon. Recommendations included advice to use complementary, not alternative therapies, yet advice to discuss CAM with a medical doctor was rare. Qualitative analysis found six CAM cancer-related frames, four in support of CAM use for cancer treatment. The dominant frame constructed CAM as legitimate tools to assist biomedicine (even to cure), with others depicting CAM as normal and necessary or as addressing limitations of biomedicine. Negative frames depicted CAM as questionable and risky practices and the industry/practitioners as possessing malevolent intent. CONCLUSION These findings have implications for biomedical practitioners attempting to determine, respect and assist patient choices about their treatment.
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Affiliation(s)
- Reegan Mercurio
- School of Psychology, The University of Adelaide, Level 4, Hughes Building, Adelaide, SA, 5005, Australia
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Phillips CB. Student portfolios and the hidden curriculum on gender: mapping exclusion. MEDICAL EDUCATION 2009; 43:847-853. [PMID: 19709009 DOI: 10.1111/j.1365-2923.2009.03403.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
CONTEXT The hidden curriculum - the norms, values and practices that are transmitted to students through modelling by preceptors and teachers, and decisions about curricular exclusions and inclusions - can be profoundly important in the socialising of trainee doctors. However, tracking the hidden curriculum as it evolves can be challenging for medical schools. OBJECTIVES This study aimed to explore the content of student e-portfolios on gender issues, a key perspective often taught through a hidden curriculum. METHODS Online posts for a gender and medicine e-portfolio task completed by two cohorts of students in Year 3 of a 4-year medical course (n = 167, 66% female) were analysed using a grounded theory approach. RESULTS A process of gendered 'othering' was applied to both men and women in the medical school using different pedagogical strategies. Curricular emphases on women's health and lack of support for male students to acquire gynaecological examination skills were seen as explicit ways of excluding males. For female medical students, exclusion tended to be implicit, operating through modelling and aphoristic comments about so-called 'female-friendly' career choices and the negative impact of motherhood on career. DISCUSSION E-portfolios can be a useful way of tracking the hidden curriculum as it evolves. Responses to gendered exclusion may be developed more readily for the explicit processes impacting on male students than for the implicit processes impacting on female students, which often reflect structural issues related to training and employment.
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Affiliation(s)
- Christine B Phillips
- Academic Unit of General Practice and Community Health, Medical School, Australian National University, Acton, Australian Capital Territory 2602, Australia.
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Weber MF, Banks E, Smith DP, O'Connell D, Sitas F. Cancer screening among migrants in an Australian cohort; cross-sectional analyses from the 45 and Up Study. BMC Public Health 2009; 9:144. [PMID: 19442312 PMCID: PMC2693134 DOI: 10.1186/1471-2458-9-144] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 05/15/2009] [Indexed: 11/14/2022] Open
Abstract
Background Limited evidence suggests that people from non-English speaking backgrounds in Australia have lower than average rates of participation in cancer screening programs. The objective of this study was to examine the distribution of bowel, breast and prostate cancer test use by place of birth and years since migration in a large population-based cohort study in Australia. Methods In 2006, screening status, country of birth and other demographic and health related factors were ascertained by self-completed questionnaire among 31,401 (16,126 women and 15,275 men) participants aged 50 or over from the 45 and Up Study in New South Wales. Results 35% of women and 39% of men reported having a bowel cancer test and 57% of men reported having a prostate specific antigen (PSA) test, in the previous 5 years. 72% of women reported having screening mammography in the previous 2 years. Compared to Australian-born women, women from East Asia, Southeast Asia, Continental Western Europe, and North Africa/Middle East had significantly lower rates of bowel testing, with odds ratios (OR; 95%CI) ranging from 0.5 (0.4–0.7) to 0.7 (0.6–0.9); migrants from East Asia (0.5, 0.3–0.7) and North Africa/Middle East (0.5, 0.3–0.9) had significantly lower rates of mammography. Compared to Australian-born men, bowel cancer testing was significantly lower among men from all regions of Asia (OR, 95%CI ranging from 0.4, 0.3–0.6 to 0.6, 0.5–0.9) and Continental Europe (OR, 95%CI ranging from 0.4, 0.3–0.7 to 0.7, 0.6–0.9). Only men from East Asia had significantly lower PSA testing rates than Australian-born men (0.4, 0.3–0.6). As the number of years lived in Australia increased, cancer test use among migrants approached Australian-born rates. Conclusion Certain migrant groups within the population may require targeted intervention to improve their uptake of cancer screening, particularly screening for bowel cancer.
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Affiliation(s)
- Marianne F Weber
- Cancer Epidemiology Research Unit, Cancer Council NSW, PO Box 572, Kings Cross 1340, NSW, Australia.
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Smith SW, Nazione S, Laplante C, Kotowski MR, Atkin C, Skubisz CM, Stohl C. Topics and sources of memorable breast cancer messages and their impact on prevention and detection behaviors. JOURNAL OF HEALTH COMMUNICATION 2009; 14:293-307. [PMID: 19440911 PMCID: PMC2718320 DOI: 10.1080/10810730902805903] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Often, people are able to recall a message on a particular topic for a long period of time. These memorable messages have the ability to influence behavior when they are recalled from memory long after initial exposure. Knowing the topics and sources of the messages that are remembered about breast cancer can improve the efficacy of future breast cancer outreach. To this end, 359 women completed an online survey about memorable breast cancer messages. Most women (60%) recalled a memorable message, described it, identified its source, and noted whether it had resulted in prevention or detection behaviors. Four categories of message topics emerged: early detection (37.3%), awareness (30.9%), treatment (25.8%), and prevention (6%). Furthermore, five categories of sources of these memorable messages were found: media (35.5%), friends (22.2%), family (21.6%), medical professionals (15.2%), and others (5.5%). The media were a major source of all four topics of messages, although family members, friends, and the medical community were major sources for particular message topics as well. Memorable messages originating from medical professionals were substantially more likely to motivate detection behaviors than prevention behaviors. This research demonstrates that message topic and source both play roles in determining message recall as well as in determining how memorable messages impacted behavior.
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Affiliation(s)
- Sandi W Smith
- Michigan State University, East Lansing, Michigan 48824-1212, USA.
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Media reporting of health interventions: signs of improvement, but major problems persist. PLoS One 2009; 4:e4831. [PMID: 19293924 PMCID: PMC2652829 DOI: 10.1371/journal.pone.0004831] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Accepted: 02/02/2009] [Indexed: 11/19/2022] Open
Abstract
Background Studies have persistently shown deficiencies in medical reporting by the mainstream media. We have been monitoring the accuracy and comprehensiveness of medical news reporting in Australia since mid 2004. This analysis of more than 1200 stories in the Australian media compares different types of media outlets and examines reporting trends over time. Methods and Findings Between March 2004 and June 2008 1230 news stories were rated on a national medical news monitoring web site, Media Doctor Australia. These covered a variety of health interventions ranging from drugs, diagnostic tests and surgery to dietary and complementary therapies. Each story was independently assessed by two reviewers using ten criteria. Scores were expressed as percentages of total assessable items deemed satisfactory according to a coding guide. Analysis of variance was used to compare mean scores and Fishers exact test to compare proportions. Trends over time were analysed using un-weighted linear regression analysis. Broadsheet newspapers had the highest average satisfactory scores: 58% (95% CI 56–60%), compared with tabloid newspapers and online news outlets, 48% (95% CI 44–52) and 48% (95% CI 46–50) respectively. The lowest scores were assigned to stories broadcast by human interest/current affairs television programmes (average score 33% (95% CI 28–38)). While there was a non- significant increase in average scores for all outlets, a significant improvement was seen in the online news media: a rise of 5.1% (95%CI 1.32, 8.97; P 0.009). Statistically significant improvements were seen in coverage of the potential harms of interventions, the availability of treatment or diagnostic options, and accurate quantification of benefits. Conclusion Although the overall quality of medical reporting in the general media remains poor, this study showed modest improvements in some areas. However, the most striking finding was the continuing very poor coverage of health news by commercial current affairs television programs.
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MacKenzie R, Chapman S, Johnson N, McGeechan K, Holding S. The newsworthiness of cancer in Australian television news. Med J Aust 2008; 189:155-8. [DOI: 10.5694/j.1326-5377.2008.tb01950.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Accepted: 06/12/2008] [Indexed: 11/17/2022]
Affiliation(s)
- Ross MacKenzie
- School of Public Health, University of Sydney, Sydney, NSW
| | - Simon Chapman
- School of Public Health, University of Sydney, Sydney, NSW
| | | | | | - Simon Holding
- School of Public Health, University of Sydney, Sydney, NSW
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Steginga SK, Gardiner R(FA. The media and prostate cancer screening. Med J Aust 2007; 187:501-2. [DOI: 10.5694/j.1326-5377.2007.tb01387.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 08/19/2007] [Indexed: 11/17/2022]
Affiliation(s)
- Suzanne K Steginga
- The Cancer Council Queensland, Brisbane, QLD
- Griffith University, Brisbane, QLD
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