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NLM Director’s Comments Transcript
Impact of Confusing Health Information: 02/25/2013

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Greetings from the National Library of Medicine and MedlinePlus.gov

Regards to all our listeners!

I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.

Here is what's new this week in MedlinePlus.listen

Confusing news coverage about diets, food, medications, and personal health stems from flawed research as well as infrequent journalistic scrutiny of researchers’ claims, suggests a recent, interesting article in Columbia Journalism Review.

The article (called ‘Survival of the wrongest’ — available at cjr.org —) contains more than 30 years of headlines about the risks and benefits of aspirin, caffeine, coffee, and red wine. The graphic is described as providing (and we quote) ‘an overview of ups and downs for these … substances’ (end of quote).

The graphic finds the take-home message from news coverage about their risks and benefits is consistently inconsistent. Some news stories about drinking coffee, red wine, or taking aspirin find they are healthy while other reports find them unhealthy.

The conflicting information about the health impacts of aspirin, coffee, caffeine, and drinking red wine raises the question (and we quote): ‘how is a consumer supposed to keep straight the conflicting claims?’ (end of quote).

The article’s author David Freedman, a contributing editor at The Atlantic and veteran health journalist, suggests conflicting information about diets, food, medications, and personal health occurs for several reasons. First, Freedman explains refereed science, public health, and medical journal editors (and authors) sometimes insufficiently scrutinize the rigor that underlies a study’s methods and outcomes, which leads to the publication of flawed findings. Second, the journalists who cover the latter studies avoid reporting the details about the research’s scientific rigor (or long range validity) and sometimes disregard their role in enhancing public understanding by publicizing less than stellar research (that tends to be subsequently rebutted).

On the scientific side, Freedman introduces the uncertainty embedded in methods and statistical inference in research about diets, food, medications, and personal health. He notes researchers sometimes do not account for an array of confounding variables in studies. He alleges clinical trials frequently either indirectly or partially assess a medication or device’s safety and efficacy.

Freedman adds many science, public health and medical journals gravitate towards (and we quote): ‘the most interesting and important findings’ (end of quote). However, Freedman explains the drawback of the latter emphasis in the long run is (and we quote): ‘the more exciting a finding, the more likely it is to be wrong’ (end of quote).

Freedman additionally criticizes journalists for not reporting the quality of a study’s methods as well as the statistical uncertainty that undergirds research findings. Freedman explains journalists have a choice; they can more frequently scrutinize and report about the veracity of a study’s claims. Or, Freedman notes journalists can make a preemptive editorial decision to avoid reporting stories about research based on less-than-impressive methodological rigor and clinical, public health generalizability.

Freedman adds (and we quote): ‘questioning most health-related findings isn’t denying good science – it’s demanding it’ (end of quote).

Freedman concludes it is time for researchers, science and medical journal editors, as well as journalists to ask themselves if publicity about less than best evidence-based diet, nutrition, and personal health research serves the greater public interest.

While Freedman does not mention health literacy in the article, MedlinePlus.gov’s health literacy health topic page notes most Americans do not understand foundational clinical information. Other health literacy research suggests is difficult to overcome misunderstandings about health when there is public confusion and frustration about the risks and benefits of familiar health issues (such as diets, nutrition, and personal health) -- that originate from the news media as well as scientific and health organizations.

More positively, MedlinePlus.gov has two pages that address health literacy and understanding medical research issues. MedlinePlus.gov’s health literacy health topic page covers the research and discussion about overcoming the poor status of the public’s understanding of clinical and public health information. This health topic page can be found by typing “health literacy’ in the search box at the top of MedlinePlus.gov’s home page. Then, click on ‘health literacy (National Library of Medicine).’

Similarly, MedlinePlus.gov’s understanding medical research health topic page helps you decipher how research is conducted and some of the challenges associated with health news coverage of research.

Two websites that help you make more sense of health news coverage (from the Nemours Foundation and Harvard Medical School) are available in the ‘related issues’ section of MedlinePlus.gov’s understanding medical research health topic page.

To find MedlinePlus.gov’s understanding medical research health topic page, just type ‘understanding medical research’ in the search box at the top of MedlinePlus.gov’s home page. Then, click on ‘understanding medical research (National Library of Medicine).’

We add it is refreshing to see a discussion about curbing confusion and enhancing the public understanding of diets, nutrition, and personal health that addresses the roles of both the scientific and journalistic communities. In addition, it is important for these issues to be raised in a publication that has strived to elevate journalistic standards for more than a half-century.

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I hope you had a very happy holiday season and enjoy a healthy New Year. The National Library of Medicine and the ‘Director’s Comments’ podcast staff, including Dr. Lindberg, appreciate your interest and company — and we hope to find new ways to serve you in 2013.