Chewing over the Churnalism: PLoS Medicine in NHS Choices

“Few things can make a doctor’s heart sink more in a clinic than a patient brandishing a newspaper clipping”, wrote Ben Goldacre in an article in the BMJ last year. (Especially if that clipping is from the Daily Mail, which has acquired such a reputation for dividing the world up into things that either cause or cure cancer that a blog – the Daily Mail Oncological Ontology Project – is dedicated to keeping a vigilant record).

Journalistic reporting of health studies was evaluated in a recent analysis in PLoS Medicine. Looking at 500 medical news stories that covered treatments, tests, products, and procedures, Gary Schwitzer, Publisher of HealthNewsReview.org, found that most stories failed to adequately address the costs, harms, benefits and the existence of other treatments options. PLoS Medicine‘s related editorial discussed the many reasons why the results of health studies can be sensationalized in the media, one of which is that press releases issued by medical journals are often prone to hype. In her blog Rebecca Walton made reference to the phenomenon of “churnalism” that can rapidly spread a misleading report or hyped release: increasingly online news sites recycle press releases verbatim and as a consequence “a lot of power lies in the hands of the press officer to shape news coverage.”

What can be done to avoid the cynical dismissal of all attempts by health reporters to explain medical research to public? Ben Goldacre praised the now defunct National Library of Health Hitting the Headlines project to better inform the public and help doctors, who on the basis of the newspaper story may be tempted to just dismiss the research cited by their patients. This has now been been supplanted by the NHS Choices Behind the Headlines service. This site is updated at an impressive rate, analyzing the health stories that break into the national news every day. The site provides a short review of the study that has attracted so much attention, comparing it to the way it is represented by the headlines, before asking what the NHS Knowledge Service can draw from the research.

In the last two weeks two PLoS Medicine papers have featured in NHS Choices Behind the Headlines. One of these was a study by Hans Bisgaard and colleagues which showed an association between mutations in the filaggrin gene (FLG) and ownership of cats with the development of eczema in infancy. The Daily Mail was so concerned about the 8 million cat owners in the United Kingdom that it definitively stated in the headline: “Own a cat and run the risk of eczema.” (This statement rather neatly avoided the fact that if you haven’t got the mutation, having a cat is not going to make you more likely to get eczema). Behind the Headlines listed the strengths and limitations of the study, as the authors do in the discussion section of the freely available article. It pointed out that the FLG mutation has only been estimated to account for about 11% of cases of eczema, so the findings will not apply to the majority of people with eczema. (The study was also covered by the Daily Telegraph, BBC News, New Scientist and Nursing in Practice, all with slightly more moderate headlines).

The second PLoS Medicine study recently reviewed on Behind the Headlines was by Rebecca Slater and colleagues. This research suggested that the currently used pain assessment tools may be underestimating the pain response in infants. The Behind the Headlines review looked at the coverage of the study by the Daily Telegraph and the Daily Mail.

Another attempt to get behind the headlines is the Australia-based Media Doctor. Like HealthNewsReview.org, it uses evaluation criteria to assess the quality of stories in the Australian press. These ten criteria include whether or not the story in question has relied on the press release. A study recently published in PLoS ONE used the ratings provided by the Media Doctor site and concluded that much of the information the public receives about complementary and alternative medicine is inaccurate or incomplete.

In a 2005 PLoS Medicine debate on the roles and responsibilities of the media in disseminating health information, David Henry and Amanda Wilson of the Media Doctor project said that many journalists have indicated to them that “they are prepared to look critically at their own practices.” And although Gary Schwitzer’s analysis of the quality of reporting of health stories in the media finds the majority to be misleading, HealthNewsReview.org does highlight examples of excellent journalism. Hopefully, these various attempts to evaluate the quality of health reporting in the media can provide cause for reflection by all parties involved in the dissemination of news and information — not just journalists, but medical journals, industry, academic institutions and individual clinicians and researchers.