Spin Doctors – How the Media Reports on Medicine

Spin Doctors – How the Media Reports on Medicine
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Even when journalists do their due diligence, they still run the risk of deceiving their readers thanks to medical journals’ own spin.

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In a study of the dietary advice given by newspapers in the UK, “no credible scientific basis” was found for most claims. The “[m]isreporting of dietary advice” was found to be “widespread and may contribute to public misconceptions about food and health.” And, potentially, not just the public.

Scientists like to think they’re not influenced by popular media, but this study decided to put that to the test. Each week, The New York Times reports on scientific research, and the studies they report on end up being cited more often than those they don’t report on. Ah, so, the popular press does have an impact.

Not so fast. That’s just one potential explanation. Maybe, outstanding articles are both more likely to be picked up by media, and independently more likely to be cited. Maybe, the newspaper was just earmarking important science, and their publicity didn’t really have any effect on future studies.

How could you disentangle the two? An event in 1978 made it possible. There was a three-month strike, in which they continued to print copies, but could not sell them to the public. So, a natural experiment was set up. If the paper was just earmarking important articles, then the strike would have no effect on the studies’ impact. But, that’s not what happened. The studies highlighted during the strike months, when no one could read them, appeared to have no impact.

The next question, of course, is: are they just amplifying the medical information to the medical community, or distorting it, as well?

Systematic studies suggest that many stories about new medicines, for example, tend to overstate benefits, understate risks and costs, and fail to disclose relevant financial ties. Overly rosy coverage of drugs may also result from financial ties between drug companies and the journalists themselves, who may be susceptible to Big Pharma perks.

Scientists and physicians often blame the press. In fact, the famous physician William Osler was quoted as saying, “Believe nothing that you see in the newspapers” and “If you see anything in them that you know is true, begin to doubt it at once.”

But, both parties share in the blame. Reporters may only have an hour or two to put together a story; and so, they may rely on press releases. And, it’s not hard to imagine how drug company press releases might be biased. But, surely, press releases from the scientists themselves, and their institutions, would present the facts fairly, and without spin, right? Researchers decided to put it to the test.

Critics blame the media. But, where do you think they’re getting the information from? One might assume that press releases from prestigious academic medical centers would be measured, unexaggerated—but they suffer from the same problems: downplaying side-effects, conflicts of interest, and study limitations, and promoting research that has uncertain relevance to human health.

For example, most laboratory or animal studies explicitly claimed relevance to human health—yet lacked caveats about extrapolating results to people. For example, a release about a study of ultrasound reducing tumors in mice, was  titled “Researchers study the use of ultrasound for treatment of cancer”—failing to note “for your pet mouse.”

Apparently, it’s been estimated that less than ten percent of animal research ever succeeds in being translated to human clinical use. Overselling the results of lab animal studies as a promised cure potentially confuses readers, and might contribute to disillusionment with science.

Although it’s common to blame the media for exaggerations, most times they don’t just make it up. That’s what the research institutions are sending out in their own press releases. And, medical journals, too. Sometimes, medical journal press releases do more harm than good. An analysis of press releases from some of the most prestigious medical journals found the same litany of problems.

I don’t think most people realize that journals sell what are called reprints, copies of the articles they print, to drug companies, which can bring in big bucks. Like, drug companies may buy a million copies of a favorable article. Sometimes, the company will submit an article, and promise to buy a certain number in advance—which is effectively a bribe, notes a long-time editor-in-chief at the prestigious British Medical Journal. He remembers once when a woman from a public relations company rang him up, and stopped just short of saying she would go to bed with him if they published the paper.

Another medical journal conflict of interest relates to advertising—a major source of income for many journals. Most of the advertising comes from pharmaceutical companies. And, so, if they don’t like a study, they can threaten to withdraw their advertising—potentially leaving editors faced with the stark choice of agreeing to bury a particular piece, or seeing their journal die.

Even if journalists have time to skip the press releases, and go straight to the source, and try to read the studies themselves, they may find them utterly incomprehensible gobbledygook. But, even if they do understand them, scientific articles are not simply reports of facts. Authors often have many opportunities to add “spin” to their scientific reports—defined as ways that can distort the interpretation of results, and mislead readers, either unconsciously, or with willful intent to deceive.

What these researchers did was look at randomized controlled trials with statistically nonsignificant results—meaning some drug, for example, was compared to a sugar pill, and the difference between the newfangled treatment and placebo was essentially nonexistent. Would the researchers just lay out the truth, and be, like, well, we spent all this time and money, and in terms of our primary outcome, we got nothing. Or, would they try to spin it? In 68% of cases, they spun. There was spin in the abstract, which is like the summary of the article. And this is particularly alarming, because the abstract is often the only part of an article people actually read.

And so, no wonder the media often gets it wrong. Spin in the abstracts can turn into spin in the press releases, and results in spin in the news. Therefore, even if journalists are doing their due diligence, using the original abstract conclusion in good faith, they still run the risk of deceiving their readers.

Researchers presenting new findings should always be careful to stress how preliminary the findings may be. But, let’s be serious; powerful self-interests may prevail.

Finally, though, I think the biggest problem with the way media reports on medicine is the choice as to which stories are covered. In 2003, SARS and bioterrorism killed less than a dozen people, yet generated over a hundred thousand media reports—far more than those covering the actual greatest threats to our lives and health.

In fact, ironically, the more people that die, the less it appears something is covered. Our leading, #1 killer is heart disease. Yet, it can be prevented, treated, and even reversed with diet and lifestyle changes. Now, that is something that deserves to be on the front page.

Please consider volunteering to help out on the site.

Image thanks to PDPics via Pixabay

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

In a study of the dietary advice given by newspapers in the UK, “no credible scientific basis” was found for most claims. The “[m]isreporting of dietary advice” was found to be “widespread and may contribute to public misconceptions about food and health.” And, potentially, not just the public.

Scientists like to think they’re not influenced by popular media, but this study decided to put that to the test. Each week, The New York Times reports on scientific research, and the studies they report on end up being cited more often than those they don’t report on. Ah, so, the popular press does have an impact.

Not so fast. That’s just one potential explanation. Maybe, outstanding articles are both more likely to be picked up by media, and independently more likely to be cited. Maybe, the newspaper was just earmarking important science, and their publicity didn’t really have any effect on future studies.

How could you disentangle the two? An event in 1978 made it possible. There was a three-month strike, in which they continued to print copies, but could not sell them to the public. So, a natural experiment was set up. If the paper was just earmarking important articles, then the strike would have no effect on the studies’ impact. But, that’s not what happened. The studies highlighted during the strike months, when no one could read them, appeared to have no impact.

The next question, of course, is: are they just amplifying the medical information to the medical community, or distorting it, as well?

Systematic studies suggest that many stories about new medicines, for example, tend to overstate benefits, understate risks and costs, and fail to disclose relevant financial ties. Overly rosy coverage of drugs may also result from financial ties between drug companies and the journalists themselves, who may be susceptible to Big Pharma perks.

Scientists and physicians often blame the press. In fact, the famous physician William Osler was quoted as saying, “Believe nothing that you see in the newspapers” and “If you see anything in them that you know is true, begin to doubt it at once.”

But, both parties share in the blame. Reporters may only have an hour or two to put together a story; and so, they may rely on press releases. And, it’s not hard to imagine how drug company press releases might be biased. But, surely, press releases from the scientists themselves, and their institutions, would present the facts fairly, and without spin, right? Researchers decided to put it to the test.

Critics blame the media. But, where do you think they’re getting the information from? One might assume that press releases from prestigious academic medical centers would be measured, unexaggerated—but they suffer from the same problems: downplaying side-effects, conflicts of interest, and study limitations, and promoting research that has uncertain relevance to human health.

For example, most laboratory or animal studies explicitly claimed relevance to human health—yet lacked caveats about extrapolating results to people. For example, a release about a study of ultrasound reducing tumors in mice, was  titled “Researchers study the use of ultrasound for treatment of cancer”—failing to note “for your pet mouse.”

Apparently, it’s been estimated that less than ten percent of animal research ever succeeds in being translated to human clinical use. Overselling the results of lab animal studies as a promised cure potentially confuses readers, and might contribute to disillusionment with science.

Although it’s common to blame the media for exaggerations, most times they don’t just make it up. That’s what the research institutions are sending out in their own press releases. And, medical journals, too. Sometimes, medical journal press releases do more harm than good. An analysis of press releases from some of the most prestigious medical journals found the same litany of problems.

I don’t think most people realize that journals sell what are called reprints, copies of the articles they print, to drug companies, which can bring in big bucks. Like, drug companies may buy a million copies of a favorable article. Sometimes, the company will submit an article, and promise to buy a certain number in advance—which is effectively a bribe, notes a long-time editor-in-chief at the prestigious British Medical Journal. He remembers once when a woman from a public relations company rang him up, and stopped just short of saying she would go to bed with him if they published the paper.

Another medical journal conflict of interest relates to advertising—a major source of income for many journals. Most of the advertising comes from pharmaceutical companies. And, so, if they don’t like a study, they can threaten to withdraw their advertising—potentially leaving editors faced with the stark choice of agreeing to bury a particular piece, or seeing their journal die.

Even if journalists have time to skip the press releases, and go straight to the source, and try to read the studies themselves, they may find them utterly incomprehensible gobbledygook. But, even if they do understand them, scientific articles are not simply reports of facts. Authors often have many opportunities to add “spin” to their scientific reports—defined as ways that can distort the interpretation of results, and mislead readers, either unconsciously, or with willful intent to deceive.

What these researchers did was look at randomized controlled trials with statistically nonsignificant results—meaning some drug, for example, was compared to a sugar pill, and the difference between the newfangled treatment and placebo was essentially nonexistent. Would the researchers just lay out the truth, and be, like, well, we spent all this time and money, and in terms of our primary outcome, we got nothing. Or, would they try to spin it? In 68% of cases, they spun. There was spin in the abstract, which is like the summary of the article. And this is particularly alarming, because the abstract is often the only part of an article people actually read.

And so, no wonder the media often gets it wrong. Spin in the abstracts can turn into spin in the press releases, and results in spin in the news. Therefore, even if journalists are doing their due diligence, using the original abstract conclusion in good faith, they still run the risk of deceiving their readers.

Researchers presenting new findings should always be careful to stress how preliminary the findings may be. But, let’s be serious; powerful self-interests may prevail.

Finally, though, I think the biggest problem with the way media reports on medicine is the choice as to which stories are covered. In 2003, SARS and bioterrorism killed less than a dozen people, yet generated over a hundred thousand media reports—far more than those covering the actual greatest threats to our lives and health.

In fact, ironically, the more people that die, the less it appears something is covered. Our leading, #1 killer is heart disease. Yet, it can be prevented, treated, and even reversed with diet and lifestyle changes. Now, that is something that deserves to be on the front page.

Please consider volunteering to help out on the site.

Image thanks to PDPics via Pixabay

Doctor's Note

If we can’t trust the medical literature on its face, where can we turn? We’re talking life-or-death information here! What we need is someone who will dig deep into the data and translate the gobbledygook into actionable tips on keeping us and our families healthy. If only there was a website we could trust to tell us the unbiased truth…

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If you think just a little spin is bad, there is a much deeper rot in the medical literature. For more on this critical topic, see:

Interested in some specific examples of the spin and conflicts of interest we’ve been discussing? See:

It’s no wonder Physicians May Be Missing Their Most Important Tool.

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