Medical Scientists and Health News Reporting: A Case of Miscommunication

Most persons, including physicians and scientists, first learn about developments in medicine through the media [1]. Press coverage of medical stories, however, is often inaccurate, superficial, or sensationalized [2-4]. Moreover, some of the most important medical issues are not covered by the press [5]. Low-quality journalism about politics or business can tarnish a reputation, but in medicine, inaccurate reporting can generate false hopes and unwarranted fears. The clinical aftermath of such inaccuracies emphasizes the need for a solution to the problem of misleading journalism. Scientists blame this problem on the press, claiming that reporters are careless about how they present medical research [6-8]. Reporters, in turn, accuse the medical community of obstructing, misguiding, or failing to alert the press [5, 9]. Media critics suggest that the difficulty lies with the audience: People must be more attentive and more skeptical when they interpret news about health [2, 3, 10]. Medical scientists alone cannot correct the deficiencies of medical news coverage, but neither can journalists. In many areas of health news reporting, the underlying problem is an interactive dynamic to which both parties contribute. We examine the roots of the problem and suggest that journalists and scientists share the responsibility for accurate communication to the public. We focus on four problem areas: sensationalism, biases and conflicts of interest, lack of follow-up, and stories that are not covered. In each area, we recommend specific strategies for physicians and scientists who are concerned about coverage of medicine in the media. Problems Sensationalism Too often, journalists pursue medical news as if they are reporting on a hostage crisis. Information is delivered rapidly, but little time is taken to provide a context for the story. Instead, the reporting is sensationalized: The journalist overstates a scientific finding and, as a result, the public is misled about the implications of that finding. This sort of reporting has its roots in newsroom pressures to dramatize stories by sounding alarms [4] or touting cures [5], but scientists and scientific institutions occasionally contribute to sensationalism. Scientists have understandable desires for publicity: It may help them get funding [8], is valued by institutions [11], and increases awareness of their research. The efforts of scientists to attract media attention, however, can result in flawed coverage. For example, press releases are issued that are inaccurate or incomplete [12] and press conferences are held even though the data being discussed are preliminary [13]. Scientific organizations invite the media to their presentations without providing explanations of epidemiologic and statistical concepts or access to scientists who can critique a given research effort. The Hazards of Calcium Channel Blockers In the spring of 1995, news wire services reported that 6 million persons in the United States who were receiving calcium channel blockers for hypertension might be increasing their risk for a heart attack by 60% [14]. Persons who were being treated for hypertension became frightened; in some cases, they stopped taking prescribed medication [15]. Physicians' offices were flooded with calls [16]. Was the reaction to the media coverage out of proportion with the findings [17]? Some believed it was and blamed the media for wreaking havoc [14, 18, 19]. However, journalists were not solely responsible for the sensationalism. In fact, journalists had been invited to the presentation by the American Heart Association and had been given a press release on the study [20]. The press release has been described as incomplete [14]. No other written materials were given out, and reporters who covered the story had little access to scientists other than the presenter. Reporters would have benefited from a more thorough written report of the study and access to persons with the ability to criticize the work. Sensationalized Hope Just as the incentive to sound alarms can push the media toward overstatement, journalists' desire to offer hope can lead to a false portrayal of new treatments. Many examples of this effect have been seen: An unusual and invasive treatment for Alzheimer disease was widely publicized after a small, unblinded pilot study [13]; fluoxetine hydrochloride (Prozac, Dista Products and Eli Lilly and Company, Indianapolis, Indiana) was hailed as a certain cure for depression when it was introduced [21]; and melatonin recently received excessively positive media treatment as a cure for aging [22, 23]. Journalists who publicize false claims can be faulted for not being skeptical, but the scientists who provide the information must share the blame. Sensational Health Risks and the Tendency To Ignore Negative Studies The negative story about potential health hazards is another sensationalistic tactic. Such stories often acknowledge only the extremes, that is, only two sides of the story: the side of the person who has been harmed and the side of the party that seems to be responsible. For example, news reports about the hazards of breast implants described a battleground on which women who feared that their implants were harming them were pitted against the manufacturers of implants [3]. Little attempt was made to enable the public to understand how scientific studies could shed light on the controversy. Instead, the journalistic drive to present a conflict [21] combined with the journalist's need for balance (equal representation of both sides) resulted in superficial reporting. Journalists argue that scientists contribute to sensational stories about health risks when they prevent the public dissemination of information [24]. In the case of breast implants, the existence of secret corporate documents that described potential hazards of implants inspired heightened press coverage and public attention [3]. Similarly, when reports of research fraud in the National Surgical Adjuvant Breast and Bowel Project emerged in 1994 [25], a key aspect of the story was the claim that researchers had failed to be honest with the public and the press [24, 26]. Inaccurate reporting about health risks is furthered by bias in the media and the medical community against negative studies. The media do not mention negative studies [27], perhaps because they seem to be inconsequential. This omission is then compounded because medical journals are less likely to publish studies that have negative results [28] and scientists are less likely to submit them for publication [29]. Recommendations 1. Researchers who present papers at meetings or publish them in journals should be available to the press to clarify and explain their findings. 2. Closed discussion of research may provoke sensationalism that open discussion could prevent. 3. Journals should make efforts to interest the press equally in negative and positive studies. Biases and Conflicts of Interest To avoid inaccurate stories, reporters need to examine the credibility and biases of scientific sources. Such examination is often not done, however, possibly because reporters are misled when the public relations efforts of scientists, institutions, or the pharmaceutical industry turn into blatant boosterism. Scientists or institutions are not wrong to invite the press to cover their research or findings; on the contrary, the media should be stimulated to provide coverage of certain issues. For example, the Centers for Disease Control and Prevention has been criticized for not doing more to interest the media in early reports on the acquired immunodeficiency syndrome (AIDS) [5]. At the same time, however, public relations efforts should be accurate. The Press Release Competition between research institutions for press coverage, combined with similar efforts by drug and device manufacturers, has resulted in medical news reporters being barraged by press kits and other materials from corporate sources, academic institutions, medical journals, and professional organizations [12, 30]. These materials can be misleading and even deceptive [31], sometimes amounting to nothing more than sensationalism [12]. Researchers can prevent inaccuracies by disallowing press conferences held to discuss preliminary data [13] and demanding final review and approval of news releases. Access to Scientists The major sources for a reporter's story on a research article or presentation are generally the authors or presenters themselves. Reporters who wish to verify such stories, however, should also speak to persons who can criticize the work. To increase reporters' access to critical sources, medical journals could release the names of peer reviewers who are willing to speak with them. When the press is invited to meetings at which peer-reviewed abstracts are presented, sponsoring organizations could also provide reviewers' names (if reviewers agree to this practice). Alternatively, journals could provide the names of experts who have published widely in the relevant field. Journals sometimes pair editorials that criticize a study with the study itself, but few studies are currently accompanied by such editorials. Disclosing Conflicts of Interest A journalist's audience should be told explicitly whether the journalist's source of information could benefit financially from the media attention or whether the source is funded or employed by an institution that will benefit. However, such conflicts of interest are often not apparent to reporters or their audiences. One example comes from a recent article about melatonin [22]. Among sources who were quoted about the anti-aging properties of melatonin was Dr. Russel Reiter, author of a popular book on melatonin [32]. Because of the book, Reiter stood to gain personally from press attention to melatonin, but the article described him only as a scientist. Reporters have become more aware of conflicts of interest bec