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Health Reporting and Its Sources

The views expressed are those of the author and are not necessarily those of Scientific American.


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Where do health and science news stories come from? The cynical answer would be "the news agency" or "the press release." Both, unfortunately, are true.

For example, for my thesis I needed to locate the sources of health stories from two major Israeli news sites. When a primary source wasn’t given I typed details from the article into Google and searched for similar stories in English. Some stories turned out to be very similar: whole paragraphs were translated from Reuters, BBC News, AP, etc. to Hebrew and found their places in the stories, usually without credit. Press releases were given the same treatment [1].

In general, there is at least a strong correlation, if not causation, between medical press releases and subsequent mass media news. Press-released papers from Tobacco Control were twice more likely to be cited than papers which weren’t included in press releases [2]. Another research found that all BMJ and Lancet papers which were covered in the Sun and the British Times were press-released papers [3].

When asked, reporters cited press releases from pharmaceutical companies, universities, university hospitals and governmental institutions as sources of ideas [4]. Of course, it’s possible that papers appear in press releases to begin with because the journals consider them "newsworthy." When a press release by a respectable institution or journal hypes research findings, news stories may follow. 

Embargo and the Ingelfinger Rule

There aren’t many scoops in health journalism; the typical health story "bursts," at once, all over the world. The reason is the Ingelfinger Rule. Named after Franz Ingelfinger, former editor of the New England Journal of Medicine (1967-77), the rule forbids authors from submitting papers to the journal if their results were already published elsewhere.

With time, other prestigious medical journals adopted the rule, and the embargo arrangement has been created: reporters get advance copies of journal issues, but agree not to write about the content until their official publication [5]. This way reporters get an opportunity to read the materials and do their research about the subject, without the pressure of being ‘scooped’. However, the by-product of the embargo is that less dedicated reporters can skip reading the paper, write an article based on information in other media outlets, and still be only a few hours behind in their reporting.  

Sources of authority

Reporters who actually write their own stories give a big amount of credit to high-impact medical journals, such as the New England Journal of Medicine (NEJM), The Lancet, and Proceedings of the National Academy of Sciences (PNAS) [6]. The most frequently cited sources in cancer stories are respectable medical institutions (Johns Hopkins University, the Memorial Sloan Kettering Cancer Institute, etc.) and medical journals, in particular the New England Journal of Medicine [7]. Journalist Boyce Rensberger wrote in A Field Guide to Science Journalism that "writing a story based on a journal article is the science-writing equivalent of a political writer covering a candidate speech or a court reporter covering a written decision handed down by a judge" [8].  

Impartial sources are hard to find

Medical journals have been called "an extension of the marketing arm of pharmaceutical companies", because industry funding can affect a study’s results and/or the way those results are presented in the paper. When a paper with favourable results manages to pass through peer-review and get published in a major journal it is "worth thousands of pages of advertising." That is, first, because people who aren’t that affected by commercials (say, your doctor) take trials published by a major journal much more seriously [9]. If the media pick up the paper as well, the pharmaceutical company can enjoy further advertising, this time straight to the general public.

This may be related to the apparent problem of industry bias for medical studies. For example, a recent review in PLoS ONE examined studies about a subject under debate, the connection between antidepressants and breast cancer. Out of 61 studies, 20 found positive cancer findings. None of these 20 had industry funding. Out of the 41 studies which had negative cancer findings, 15 had industry association [10].

Thirty-two percent of the randomized trials appearing in the NEJM in 2005-2006 were industry-funded. Industry-funded papers are good for medical journals because they tend to get cited more frequently, which allow the journals to keep a high impact factor. The journals benefit further from selling reprints of industry-supported trials [11].

When JAMA The Journal of the American Medical Association started to insist on independent statistical analysis for industry-supported trials, the number of industry randomized controlled trials (RCT) published in it decreased significantly. At the same time, the proportion of industry RCTs published by the NEJM and the Lancet went up significantly [12]. Since health reporters tend to put their trust in studies published in elite scientific journals, they might be passing the industry bias to their readers.  

Improving health reporting – Media Doctor sites

Media Doctor sites have been founded in order to improve health reporting, and represent a new and welcomed trend of watch-dogging the watchdogs. These sites each have a team of professionals (medical doctors and researchers) who review health stories about treatments, procedures, tests, etc. and display the ratings in the Media Doctor site as well as send them to the relevant reporters. The reviewers rate the stories according to ten criteria including: going beyond the press release, disease mongering, establishing the novelty of the approach in the story, and so on.

Originating in Australia, Media Doctor sites have been established in Canada, Hong-Kong, Germany and Japan (the U.S. version is called HealthNewsReview, but is essentially the same). The UK version, Behind the Headlines, is slightly different and more public-oriented. It’s a part of the British NHS site and focuses on analyzing well-covered health stories from the mass media in everyday language. Regardless of their names, all these sites help health news readers become better informed. 

References  

[1] Shema, H. & Bar-Ilan, J (2010). Sources of health articles in Israeli news sites. Meida’at (6), 46-64. [Hebrew]  

[2] Chapman S., Nguyen T. N., White, C. (2007) Press-released papers are more downloaded and cited. Tob Control, 16(1), 71.  

[3] Bartlett, C., Sterne J. & Egger M (2002). What is newsworthy? Longitudinal study of the reporting of medical research in two British newspapers. BMJ, 325, 8184.  

[4] Van Trigt, A., De Jong–Van Den Berg, L., Haaijer-Ruskamp, F., Willems, J. & Tromp T. (1994). Journalists and their sources of ideas and information on medicines. Soc Sci Med. (38), 637 – 643.  

[5] Altman, L. (1996). The Ingelfinger rule, embargoes, & journal peer-review part 1. Lancet, 347, 1382-8.  

[6] Conrad P. Uses of expertise: sources, quotes, and voice in the reporting of genetics in the news.Public Underst Sci. 1999;8:285–302.  

[7] Moriarity, C. M., Jensen, J. D., Stryker, J. (2010). Frequently cited sources in cancer news coverage: a content analysis examining the relationship between cancer news content and source citation. Cancer Causes Control (21), 41–9.  

[8] Rensberger, B. (1997). Covering science for newspapers. In Blum, D. & Knudson, M. (Eds.). A field guide for science writers (pp. 7-16). New York: Oxford University Press,  

[9] Smith, R. (2005) Medical journals are an extension of the marketing arm of pharmaceutical companies. PLoS Med 2(5):e138.  

[10] Cosgrove, L., Shi, L., Creasey, D. E., Anaya-McKivergan, M., Myers J. A., et al. (2011) Antidepressants and breast and ovarian cancer risk: A review of the literature and researchers’ financial associations with industry. PLoS ONE 4(6): e18210. doi:10.1371/journal.pone. 0018210  

[11] Lundh, A., Barbateskovic, M., Hróbjartsson, A. & Gøtzsche, P. C (2010) Conflicts of interest at medical journals: The influence of industry-supported randomised trials on journal impact factors and revenue – cohort study. PLoS Med 7(10): e1000354. doi:10.1371/journal.pmed. 1000354  

[12] Wager E, Mhaskar R, Warburton S, Djulbegovic B (2010) JAMA published fewer industry-funded studies after introducing a requirement for independent statistical analysis. PLoS ONE 5(10): e13591. doi:10.1371/journal.pone. 0013591

About the Author: Hadas Shema is an Information Science graduate student at Bar-Ilan University, Israel. She studies the characteristics of science bloggers and is a member of the European Union’s Academic Careers Understood through Measurement and Norms (ACUMEN) project. Hadas blogs at Science Blogging in Theory and Practice.

 

The views expressed are those of the author and are not necessarily those of Scientific American.






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