Three Reasons Why You Should Ignore Healthcare Headlines
Why the news can be downright misleading.
Posted Dec 25, 2017
Last April, during a week when the news featured missiles being fired from North Korea and Mike Pence using the words “pre-emptive” and “nuclear strike” in the same sentence, a story about prostate cancer screening made the top two news stories.
The peculiar thing: The news merely announced that JAMA was publishing draft guidelines on prostate cancer screening. Not new guidelines—revised, draft guidelines. The more you looked into the story, the more bewildering the headlines became. The draft guidelines helpfully informed readers that, while they might consider getting screened for prostate cancer, all forms of screening earned a “C” grade, at best—and a “C” grade in the current, grade-inflation sense of “C,” as in a hair’s breadth from failing. And, if you were aged 70 or older, forget about prostate cancer screening entirely. The only thing striking about these guidelines was that the task force issuing them, the US Preventive Services Task Force (USPSTF), had in 2012 declared that prostate cancer screening did more harm than good and that men should steer clear of it. Now, the USPSTF was telling men that prostate cancer screening was a good idea...kind of, sort of.
At least the healthcare headlines in this case had some kind of transparency to them, even if the guidelines themselves bordered on gnomic. Readers could, after all, turn to the USPSTF’s own website and read the guidelines. Although, in this instance, the guidelines themselves violated almost every journalistic dicta for clear writing, including using concrete language, familiar terms, and directly addressing an audience of men who might be fretting that the overactive bladder keeping them up at night was a symptom of the prostate cancer that would kill them. (Note to men of a certain age: probably not).
For those of us navigating the healthcare headlines and considering dramatic changes to our diets, exercise, and lifestyles—always a hot topic with the new year looming, a short-hand guide to why you should ignore these items making the news.
1. Most healthcare stories making the news are woefully short on the details that scientists regularly use to assess the integrity of studies.
New stories usually fail to note whether the claims have clinical data behind them, as in a story Allure magazine printed about dermatology that came from the journal Medical Hypotheses, a journal that mainly publishes articles about (surprise, surprise) hypotheses without a shred of clinical data. Today, even dodgy pay-to-play journals claim to have peer reviews, which seem to involve passing manuscripts among in-house editorial staff who make suggestions for improving the article. Or they just approve the article’s acceptance immediately—for a hefty fee.
2. Even when studies have clinical data behind them, journalists seldom ask the right questions about the study’s design.
Consider an oft-cited article in the Harvard Business Review about power posing. Researcher Amy Cuddy and colleagues discovered that merely assuming a man-spreading, arms-akimbo or outstretched "power pose" increased testosterone and lowered stress hormone cortisol levels. This brief power pose thus gave participants greater self-confidence and dominance when they made presentations or underwent interviews. The Wall Street Journal, among other well-respected news outlets, ran with the story.
However, the power pose story had three things going against it. First, other studies were unable to replicate the finding—a development guaranteed not to make headlines unless the finding is the miracle of cold fusion, later discovered not to be a miracle and, in fact, an impossibility. Second, hormones like testosterone and cortisol wax and wane according to a variety of factors that have nothing to do with man-spreading at a desk for three minutes, including age, socio-economic status, and hormonal cycles. Third, biomedicine is inevitably cursed with the law of small numbers, where too little information leads us to make incorrect generalizations. To avoid this curse, researchers need data on as many as tens of thousands of participants or data collected over long periods of time—not a five-minute test administered to a small group of volunteers. However, in biomedicine and in most research, you need money and willing participants, which translates into initial studies that make general claims based on effects that vanish when you look at 50,000 people or a year's worth of data.
3. Journalism strives to convey simple stories, eliminating details that cloud conclusions.
Everyone who’s needed to lose 15 pounds for the past decade draws inspiration from mass media stories that inevitably crop up between Christmas (where you may pack on an extra 5 lbs) and New Year. Actually, that scenario is now close to best-case, as more readers turn for inspiration to reddit, Facebook, and blogs busily making money off the precise remedy they’re reporting. Nutritional studies, in particular, are tricky, as long-term studies rely on participants self-reported diet and exercise, an area where participants notoriously under-report the calories they eat and over-report their exercise. Even studies that sequester participants in setting that control their diet and exercise represent simplified, short-term snapshots of complex interactions. For instance, we now know that environmental factors influence gut microbiota that, in turn, play a role in obesity, regardless of the number calories you consume.
Should you just ignore news stories about health and wellness? Well…yes and no. If you’re reading Facebook, reddit, or the Daily Mail, yes. Even if you’re reading the Wall Street Journal, consider the sources the story uses and even the journalist’s credentials. And ponder everything from the size of the study to the things the study claims to measure.
You might find that being skeptical is harder mentally than being accepting. But being skeptical can also lead to healthier decisions in the long run.