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Score and Ignore: a Radio Listener's Guide to Ignoring Health Stories

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Score and Ignore: a Radio Listener's Guide to Ignoring Health Stories Score and ignore A radio listener’s guide to ignoring health stories Do you shout at the morning radio when a story about a medical “risk” is distorted, exaggerated, mangled out of all recognition? Does your annoyance ruin your breakfast? You are not alone. Kevin McConway and David Spiegel- halter have developed a defence strategy to save their start-of-the-day sanity. Strike back at the presenters! And make it personal… When we wake up we are among the millions all of reporting, and applicability. In each case, a weaned] are more likely to eat fruit over the UK who turn on the Today programme on “yes” answer to the question indicates some and vegetables when they are older BBC Radio 4, presented by our favourite, veteran cause for concern about the report or the study than those given meals from jars and and generally excellent reporter John Humphrys. it is reporting on. A score of 12 “no” answers packets, researchers say.” This could be All over the US millions more tune in to simi- implies a perfect study, perfectly reported; 12 because the home-cooked food causes lar early news programmes with their own pet “yes” answers calls for apoplexy and vituperative the later eating behaviour, or it could be presenters. On many mornings there is a report letters to editors. Here goes: because some other aspect of the babies’ on the latest health risk story. At work we flip upbringing (a confounder) is associated through popular newspapers and there are more Study quality with both the weaning food and the later stories reporting the latest “research”, for exam- • Just observing people? diet. Wealth, social background, and ple on proposed links between cats and cancer Is it purely an observational study, whether both parents are working would or mobile phones and asthma. Our irritation at that is, did it just involve observing be obvious confounders here. Or there the uncritical coverage these stories generally and recording what people did when might be some reasons for a system- receive has occasionally led to loud verbal abuse left to their own devices? You cannot atic bias – for example, in asking people of the radio and of its presenters and journal- infer cause rather than correlation unless about their past use of mobile phones, ists, to the detriment of peaceful digestion of there is some controlled experimental people with a brain disease might simply toast and coffee and of the domestic harmony aspect in which, ideally, people have be more likely to recall higher usage than that should greet the new day. Our families and been randomly allocated to different people unaffected by the disease. A well- colleagues have encouraged us towards a more interventions or treatments. reported story would draw attention to creative response. • Yet another single study? issues like this. A less good effort might We have therefore constructed a simple Is it just one isolated study, which does not, but you can still use your ingenuity checklist for scoring such health stories. It is not place the new findings in the broader to think about what alternative explana- aimed at general consumers of media reports, so context of what is known? No single tions are plausible. it concentrates on issues about the news process, study is sufficient to draw a firm conclu- • Small? how the story came to be reported, and what has sion. The ideal is to pool systematically Size matters. If the number of people not been reported. Our key concern is the overall the evidence from all available studies, studied is too small (as a rule of thumb, value of the story to a listener or reader as a as is done in reviews carried out by the in the tens rather than hundreds or thou- source of reliable information relevant to his or Cochrane Collaboration. sands), then it might well be misleading. her own health. • Might there be a different explanation that It can take some technical expertise to you are not told of? be clear about what an appropriate size Is there some plausible explanation for is for a particular study, but your intui- Our checklist the results, other than the explanation tion should at least allow you to smell that you are being given? For example, a rat. It is usually the number of events Our checklist has 12 separate items, relating one press report1 began: “Babies fed that is important, not the total number to three broad aspects: study quality, standard home-cooked food [when they are of individuals studied, so there might be © 2012 The Royal Statistical Society october2012 45 Credit: Tom Boulton a study of a very rare disease where mil- IARC’s own press release3 on which the • Public relations puff? lions of people were followed up but only story was based. However a decision on Ask yourself: “Why am I reading this?” a handful got the disease – that makes it whether to score this item is not always Things that look superficially scientific a small study. clear-cut. Headline writers are limited to and objective may just be the product a handful of words – and they do have to of a PR process, so check who sponsored Standard of reporting try to make those words interesting. the work. It is worth asking whether the • Original information unavailable? • No independent comment? original study report was subject to peer It might be going too far to expect a link Does the story seem just to be parroting review. But beware, the most respectable to the original report in a brief printed a press release? Does it look at just one journals can err – remember that Wake- press story, but you should at least be side of the story? Are there no quotes field’s erroneous speculations on autism able to find the original source by a sim- or comments from other scientists? The and vaccination appeared first in the ple Internet search – even if, once you comments do not have to be negative. Lancet. Further, stories may be newswor- have found it, it is behind an expensive But comments from people with an obvi- thy without actually being substantively paywall. But at least you may be able ous vested interest do not count. very important; this often happens when to read the abstract and/or the press • “Higher risk”? the story mixes the mundane with the release for nothing. Does the story just tell you comparative dread (such as relating cats to cancer, • Headline exaggerated? (relative) information, like how much or relating babies’ bottles to all kinds Is it exaggerated beyond what the origi- greater the risk is if you are exposed to of scary symptoms and diseases). Or a nal study report said? For instance, in the potential hazard compared to if you story may have been made to look more reporting on the International Agency are not? Relative information does not newsworthy because it is “disease- for Research on Cancer (IARC) decision to on its own inform decisions (essentially mongering”4 – exaggerating, over-selling list the radiation from mobile phones as because twice not very much is still not or over-medicalising a condition. “possibly carcinogenic to humans”, the very much). Ideally the story should give • Half the picture? Daily Express2 used the headline “SHOCK absolute numbers – what is the chance Ask yourself: “What am I not being told?” WARNING: MOBILE PHONES CAN GIVE YOU of the disease if you are not exposed to More broadly, does the story look at all as- CANCER”. This went considerably beyond the possible risk factor, and what is the pects? Many substances that might harm the relatively measured tones of the chance if you are exposed? your health might also have benefits, and 46 october2012 ring as many alarm bells as providing adverse Box 1. Magnetic fields and asthma information). Count up the points. The nearer A report5 on a possible link between exposure everyday (babies) with the dread (radia- the score is to 12, the less notice you should to low-frequency magnetic fields in pregnancy tion), and this is probably the reason it take of the story and the more you should ignore and asthma in the children resulting from the is receiving publicity. It is in the “print it it lest it ruin your day. pregnancy was published on the Reuters web- because it will sell our paper” category, To make it easier, it is well known that a site. Our scoring is as follows. rather than “print it because it is vital mnemonic can assist greatly in making a check- the world should know”. list useful. We can reorder the items so that the J Just observing people? H Half the picture? initials give: Yes. The study was clearly observational. Yes. This is slightly tricky. Further in- O Original information unavailable? vestigation reveals that investigating J Just observing people? No. There is no link to the original study, asthma was essentially an afterthought O Original information unavailable? but it is very easy to find in an internet in a study that was originally about H Headline exaggerated? search, given that the journal and lead something else. But this was not stated N No independent comment? author are named. in the Reuters story. H Headline exaggerated? R Relevance unclear? H “Higher risk”? No. The headline was “Magnetic field No. The study is relevant to someone who U Unjustified advice? exposure linked to asthma risk”. It sum- is pregnant, or planning to become preg- M Might be explained by something else? marised the story. nant, though it is not entirely clear what P Public relations puff? N No independent comment? one might do to avoid this radiation.
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