Scientific Journalism: the Dangers of Misinformation
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Commentary CONTROVERSIES IN PSYCHIATRY Scientific journalism: The dangers of misinformation Journalists can mislead when they interpret medical data instead of just reporting it he 2011 movie Contagion portrays chaos resulting from the emergence of a highly lethal, rapidly pro- T gressing virus threatening to end civilization. One of the characters, a freelance journalist with a blog followed by 15 million people, directs his readers to ignore an effec- tive vaccine the CDC has developed, assigning conspirato- rial motives to the CDC’s efforts. During a nationally televised 2011 presidential candidate debate, Representative Michele Bachmann created a con- troversy when she stated fellow candidate Texas Governor Rick Perry’s policy requiring sixth-grade girls to get vac- cinated against the human papillomavirus exposed them to potential dangers. © IMAGEZOO/CORBIS Much has been written about the potential influence poli- ticians and mass media have on the public’s understanding William Glazer, MD President of scientific knowledge. Carvalho wrote, “The media have a Glazer Medical Solutions crucial responsibility as a source of information and opinions Key West, FL about science and technology for citizens. Public perception Menemsha, MA and attitudes with regard to those domains are significantly influenced by representations of scientific knowledge con- veyed by the press and other mass means of communication.”1 Recently, media attention generated by some critics—eg, professional journalists, nonmedical academics, and non- psychiatric physicians—has questioned the effectiveness of antidepressants. These individuals are affecting public understanding of the issue. Scientific journalism vs scientific discovery Journalism exists in many forms—eg, advocacy, scientific, Current Psychiatry investigative—and has led to positive and negative social Vol. 12, No. 6 33 and cultural changes. Scientific journalism Experts submitting manuscripts to peer- interprets information to make it interest- reviewed journals are not paid based on ing and understandable to readers. Ideally, sales or impact factor. The literary style of journalists select what is newsworthy the expert often is dry and technical com- and provide balance to disputed themes pared with journalistic style. Academic with careful attention to the facts. authors are interested in promoting ideas Sometimes, a scientific journalist may that ultimately benefit the patients’ wel- Journalism and render his or her opinion on the topic, ex- fare. In contrast, most journalists have an psychiatry plicitly or implicitly. When this occurs, the invested interest in selling their work or journalist may reflect the state-of-the-art increasing their blog following. Sustaining accurately, or he or she may present biased book sales can be a powerful personal in- journalism. centive to cast the discourse in a compel- Although the modus operandi of a jour- ling way, one that may counter prevailing nalist can differ significantly from that medical opinion. of an expert conducting scientific inquiry, Of course, academic authors can ben- I do not intend to render a judgment efit from publications in the form of Clinical Point about the superiority or inferiority of grant support, scholarly authority, and Disclosing conflicts of either group. Both groups have the abil- notoriety. At times, these benefits can lead ity to impact discovery, negatively and to personal financial gain, eg, collabora- interest in journalism positively. tions with industry or compensation as occurs internally Scientific experts acquire and report a part of the scope of their work in their as a function of an scientific evidence regarding depression. academic institution. This leads to the is- individual publisher’s Additionally, they develop professional sue of disclosure. Disclosure has been a guidelines to provide practical advice to hot topic in medicine, and has led to the policy clinicians who wrestle with the challenges creation of the Physician Payment of treating depression. Journalists are not Sunshine Act,2 which is set to take ef- trained to render medical judgments about fect August 1, 2013. Contained within the the data; they simply report it. Affordable Care Act, this law will require Experts rely on pure transparency from pharmaceutical companies and other the initial hypothesis through the design, medical industries to report all direct pay- methods, results, and conclusions. In con- ments or gifts to physicians >$10. With trast, journalists enjoy the time-honored such disclosure, readers can judge the ex- privilege of hiding sources’ identities. perts’ work with knowledge of what finan- Before a scientific expert’s paper is cial relationships may be in place. published, he or she must negotiate a peer review process in which his or her writ- ing is subjected to the scrutiny of qualified No disclosure laws for journalists experts in the same field, a process that In contrast, the public is not privy to can last months to years. Journalistic journalists’ potential conflicts of interest. methodologies also include editorial over- Although journalism has no “Sunshine” sight, but it’s fair to say that the peer re- equivalent, there’s a culture of disclo- view process for scientific publication sure3 that is followed rigorously by some generally is more rigorous than editorial publishers and less rigorously by others. reviews of journalism, because the jour- Disclosing conflicts of interest in journal- nalistic review process serves the goal of ism occurs internally as a function of an Discuss this article at generating “news” for a hungry market- individual publisher’s policy. Would a www.facebook.com/ place of ideas. Journalists pick and chose “Sunshine” law applied to journalism af- CurrentPsychiatry their content, hopefully in a balanced fect how readers interpret a journalist’s re- fashion, but at the discretion of the jour- jection of the validity of prevailing expert nalist and his or her editor. It’s relatively views? Would such articles be more under- quick and easy for journalists to publish a standable if the public sees the amounts of book or newspaper article, and even easier journalists’ royalty checks, their collected Current Psychiatry 34 June 2013 to publish a blog. fees for participation in their blogs or re- lated advertising, or contributions from organizations that are against psychiatry? Related Resources • U.S. Department of Health & Human Services. The Affordable Care Act, section by section. www.healthcare.gov/law/full/index.html. Skewed coverage of psychotropics • The New York Times Company policy on ethics in journalism. There are well known cases in which a www.nytco.com/press/ethics.html. scientific journalist has been criticized for • Pew Research Center’s Project for Excellence in Journalism. Ethics codes. www.journalism.org/resources/ethics_codes. conveying speculation as fact, eg, global Disclosure warming1 and immunizations.4 I am con- Dr. Glazer is a speaker for Merck and Otsuka America cerned we are experiencing this problem Pharmaceutical, Inc. in the case of antidepressants and other psychiatric medications. Depression poses an extraordinary pub- lic health problem and there’s a tremen- public, especially when it runs counter to dous need for innovation in treatment and prevailing professional opinion. improved patient outcomes. Most scientific One example can be seen in a blog from experts agree that we do not understand the The Chronicle of Higher Education.7 John Clinical Point pathophysiology underlying depression nor Horgan, a professional journalist, describes Those who wish to the mechanisms of action of antidepressants. a friend who has a depressed teenage son But, as with many other medical disorders and refers to the work of other journalists voice an opinion via that are not yet clearly understood, clear and selected experts to discredit antide- scientific journalism professional guidelines for depression treat- pressants’ benefits. A quick review of read- should be obligated ment are in place.5 These guidelines testify ers’ comments demonstrates how articles to follow the rules of to the complexity of treating depression and like this one can mislead consumers to the scientist, not the unambiguously support the value of anti- reject what may be the best treatment op- depressants as a major component of treat- tion for depression. When journalists draw journalist ment. Guidelines such as these are derived their own scientific conclusions, rather from careful interpretation—a vetting pro- than simply report on the conclusions cess—of data. Participation in this process reached by scientists, there’s a potential for should not be limited to scientific experts, misinformation and confusion. but the interactions required in the vetting process should be subject to rules of scien- tific inquiry. Guidelines may help A scientific journalist usually chooses What can be done about the potential im- his or her experts and sources at his or her pact of unvetted journalism on individual discretion, free of the vetting practice de- patients? I am not against an open dia- scribed above. There are recent instances in logue about the risks and benefits of anti- which journalists have formulated innuen- depressants, but given the complexity of dos drawing upon published research and the issue, I argue that anyone who wishes “connected dots” that may not coincide with to voice an opinion via scientific journal- prevailing expert opinion.6 This kind of jour- ism is obligated to