Health in the news: Discussion

Recently David Rothman published a post in which he talked about "sites that critique journalism." These sites exist in order "to fill the information gap which can arise from:

• confusion caused by media reports on the publication of new scientific studies relating to the same medical area, but with contradictory conclusions;
• inaccuracies in some media reporting caused by - difficulties in communicating complex medical information to a non-medical audience; over-zealous sub-editing to make news items/articles 'fit to size' and the issuing of press releases, by medical journals, which may not always report limitations in newly published studies - leading to further miscommunication of information;
• a reluctance from some doctors to speak to the media, due to perceptions within the medical profession that doctors may be misrepresented or misunderstood;
• public perceptions that 'official' medical or scientific advice may be influenced by policy matters; and
• difficulties in knowing where to obtain independent quality-assured medical information. (Behind the medical headlines: about, retrieved 29 Jan. 2009)
  

I've being thinking about this a lot lately and have been meaning to write about it. My particular peeve has to do with the fact that news articles rarely, if ever, cite their sources. Articles in the news will at most mention in passing that such and such study was published in the October issue of the New England Journal of Medicine. The researcher's names are usually mentioned.

That is enough information for me to find the article, but is it enough for the lay person? Since a big part of my job is teaching health professionals how to find articles they sometimes have difficulty finding when they have the complete citation and access to McGill's full complement of journals and databases, I suspect that it is not enough for your average person reading the paper.

It took me half an hour of skilled digging to find the research discussed in this article a friend recently posted to Facebook: Surrounded by friends? It's all in your genes. Eventually "...I was able to find out that it was published in the Proceedings of the National Academy of Sciences in the Early edition ("published online before print January 26, 2009") which is available by subscription only- the copy I have linked to here is not the final published draft."*

Interestingly the proper citing of sources does not seem to be considered of much importance by the sites mentioned by David, or the site I usually recommend (Behind the medical headlines). Health News Review.org states that

An Unsatisfactory story may:
• Fail to identify the source of the story (news release, journal article, editorial, scientific meeting presentation, etc.) and fail to make obvious the extent to which that source is likely to be conflicted... (Health News Review: About us, retrieved 29 Jan. 2009)

Media Doctor.ca states that "No mention of sources or possible conflicts of interest" (MediaDoctor: Rating information, retrieved 29 Jan. 2009) is unacceptable in all relevant categories (Diagnostic Test, Harm Stories, Other, Pharmaceutical, Surgical Procedure). However, mentioning or identifying information sources is not the same as providing enough information about the sources that they can be easily accessed.

How difficult is it to include the journal issue and volume? Since more and more medical research is becoming freely available thanks to open access initiatives, why not go so far as to include a link to the full text? And if it is as yet unpublished shouldn't that be mentioned too?

I am continually emphasizing to patients and their families the importance of evaluating consumer health information resources, and one of the most important criteria is precisely: does the resource cite its sources? The HonCode lists this as number four out of eight principles that need to be followed in order to be certified. The National Cancer institute lists it fifth on its list of criteria, and the American Medical Library Association lists it third.

When will news media be held to the same principles?


*Speaking of citing your sources, to be honest I'm not sure how to cite something that I wrote in a Facebook post. If anyone can tell me I'd be glad to know. In any case my comment was posted on at 8:14am January 28.

IBS: Challenge

I get a lot of questions about irritable bowel syndrome (IBS), so I thought I would feature it today. It is another one of those conditions that gets you a list of questionable sites intermixed with authoritative ones.

As usual it is not always easy to tell one from the other, and some of the less trustworthy ones are often the most tempting because they make promises and sometimes seem to have more detailed information.

Trustworthy sites rarely, if ever, make promises, and can be very general which may be discouraging. But promises and information that are not evidence-based are unfortunately not worth much. Evidence Based Medicine provides a very good and easy to understand explanation of, you guessed it, evidence-based medicine and why it's so important.

Of course sometimes the reason there is no evidence is that the research hasn't been done, which can also be frustrating.

Another thing to keep in mind is that even trustworthy sites recommend treatments that haven't yet been approved by, say, Health Canada, but have by the FDA, the European Medicines Agency (EMEA), or whatever your country's equivalent of these bodies is (or vice versa), so it's important to be aware of what country the information is coming from.

If you are ever unsure whether you can trust a source of information, ask your health care provider, local librarian, or ask me and I'll be happy to help. The Oakland Public Library gives some good suggestions for how to judge online health information, and Behind the Medical Headlines provides expert commentary on what you're hearing about in the news.

Behind the Medical Headlines aims to provide the public and health professionals with authoritative and independent commentaries from leading medical experts on articles or news items which appear in our daily media (nationally and internationally) in an attempt to reduce the confusion which can often arise from conflicting, incomplete or misleading media reports of medical areas.

And don't forget to check for the HonCode symbol .


Finally, here are some of the evidence-based consumer resources I recommend for IBS:

Irritable bowel syndrome: tips on controlling your symptoms (American Academy of Family Physicians)
Irritable bowel syndrome (National Library of Medicine)
IBS diet: can yogurt ease symptoms? (Mayo Clinic)
Symptoms of IBS (International Foundation for Functional Gastrointestinal Disorders)
Irritable bowel syndrome (IBS) Health Center (WebMD)
Should I have tests for irritable bowel syndrome? (WebMD)
Irritable bowel syndrome: Controlling symptoms with diet (WebMD)