Spin Doctors – How the Media Reports on Medicine

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