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Does Science Need More Compelling Stories to Foster Public Trust?

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


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The touching stories that advocacy groups are so good at telling—the 49-year old mother whose breast cancer was detected by an early mammogram before it had spread; the 60-year-old neighbor who had a prostate tumor removed thanks to a routine PSA test—should inspire scientists to use anecdotes of their own, argue two doctors from the University of Pennsylvania.

In the scientific realm, anecdotal evidence—the individual patient, the single result—tends to be shunned in favor of large, dense data sets and impersonal statistical analyses. Although that foundation must remain the core of solid research, examples and narratives should be invoked to round out the explanation of what the hard science says, Zachary Meisel and Jason Karlawish, both of the Perelman School of Medicine at Penn, contended in an essay published online Tuesday in JAMA, Journal of the American Medical Association. “Stories are an essential part of how individuals understand and use evidence,” they wrote. And they can have a powerful effect on public opinion and policy.

“Each time, those who espouse only evidence—without narratives about real people—struggle to control the debate. Typically, they lose,” Meisel and Karlawish observed. In the wake of recommendations for reduced breast and prostate cancer screenings from the U.S. Preventive Services Task Force, many cancer survivors and cancer advocacy groups jumped in to tell the stories of how early screening had saved lives.

Many scientists point out that these stories and stats can be misleading because overall survival also increases when more non-life-threatening cancers are detected—and misses the many potential downsides to untargeted screening. That’s where scientists can step up with stories of their own, such as that of the young woman who underwent a series of invasive and stressful biopsies only to reveal that a mass in her breast was not malignant—or the example of the middle aged man who was rendered incontinent after surgery to remove a prostate growth that was not likely to have killed him. Compelling stories could also help counter unwarranted fears about childhood vaccines, by telling the tale of one of the many unvaccinated children who got measles because parents were worried about the purported link to autism.

Relatable, first person narratives could also make the scientific process much clearer and more accessible. If, before releasing the publicly controversial—but evidence-supported—2009 guidelines on mammography, the U.S. Preventive Services Task Force had explained their own process and personal deliberations, it might have built “a substantially more compelling perspective” rather than prompted “a confused and angry public” response with dehumanizing statistics, Meisel and Karlawish asserted.

And the dry old scientific data supports this notion. “Narratives, when compared with reporting statistical evidence alone, can have uniquely persuasive effects in overcoming preconceived beliefs and cognitive biases,” the researchers noted.

Katherine Harmon Courage About the Author: Katherine Harmon Courage is a freelance writer and contributing editor for Scientific American. Her book Octopus! The Most Mysterious Creature In the Sea is out now from Penguin/Current. Follow on Twitter @KHCourage.

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





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  1. 1. billsmith 2:21 am 11/9/2011

    Ethos, pathos, logos… You need all three.

    Link to this
  2. 2. priddseren 2:25 am 11/9/2011

    Compelling stories are not the problem. Science has been inundated with a plethora if theories being pushed on the public like a priest would push his religion. Take global warming, their proof of human caused global warming is all anectodal and primarily based on computer models not observation. In medicine, it is the ever ending parade of drugs to fix this, fix that, solve X then taking 27 other drugs to counter the side effects of the first dozen prescribed all with disclaimers they may not work, could cause body parts to grow where they should not or fall off where they shouldn’t, assuming the drugs dont kill you first.

    This has been going on a long time. Politicians deciding animal fat was bad in the 70s, with no actual evidence has resulted in Type II diabetes and obesity problems which never existed before and the list goes on. It is a joke, based on science, everything you can eat, drink, breathe, wear, look at or conteplate will kill you.

    What science needs to do is first get out of producing government biased results, too much of the government funding research with an agenda is happening. Scientists have to realize the population is in fact more intelligent as a whole and are capable of looking into the data themselves to some degree. So if an outlandish or even unexpected claim comes along, the scientist must be completely accurate with his data and results because people will check it. Scientists also need to be prepared to accept new evidence. For example, Clovis first beliefs were proven wrong by archeologists a couple decades ago but it took this long for “the establishment” in this field to finally accept it.

    That all said, there is a bit of a marketing issue as well. The story is correct that selling the truth does take effort. The reason the compelling stories work to sell the idea is because like any lie, people will believe it if they fear it is true or want it to be true. That is the basis of the global warming scam. Some fear it is true for whatever reason and believe the hype. Others want it to be true because it fits their agendas, either the humans are evil agenda or the we want to scam the public to buy into the green companies we invested in agenda.
    Magic cures for cancer, obesity or any other medical problem work the same way.

    So science needs to be accurate with their data and analysis, produce accurate results but learn how to market this stuff in a way that people will accept the truth when it is right there to see. Hiding data or actiung like the population cant understand data or science will not work though.

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  3. 3. geomom 8:27 am 11/9/2011

    Priddseren, the point is that, unfortunately, most of the public cannot understand scientific data.

    Looking at the world through statistics that way is not intuitive for our brains and must be taught. Steven Pinker talks about this in The Blank Slate. Our brains didn’t evolve to deal with statistical data–they evolved to deal with an immediate threat. And most decision-making, we are told, is based on emotion more than facts.

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  4. 4. jtlespoosta 9:42 am 11/9/2011

    It is quite right that the public is not overly trusting on science. In Western countries, too, cruel experiments have been carried out on humans in the name of science.

    Sometimes scientists have commercial and other agendas. Sometimes governments try to limit availability of information that contradicts assumptions behind their policies.

    We know already of medical journals that have published studies authored by ghost writers sponsored by pharmaceutical companies. Economists as a rule do not publish their commercial affiliations, and may promote policies that favour financial institutions or other special interests groups.

    There is a need to make the general public more aware of these caveats. Not to mention ties that publishing houses, radio- and tv-stations, politicians and government officials have.

    Help us keep our eyes open, not to develop clever first-person stories that pull wool over our eyes.

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  5. 5. boissephil 10:02 am 11/9/2011

    Emotion sways opinion more effectively than logic, even for scientists.

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  6. 6. geojellyroll 10:40 am 11/9/2011

    pridserrian…excellent post

    Science and agenda don’t mix.

    Anecdotes, advocacy, etc, are fine but NOT the realm of science.

    As a geologist for 34 years I cringe everytime I read ‘scientists say….blah, blah…’. It’s usually one or 2 researchers making an off the cuff remark trying to ‘dumb down’ results to answer the inquiries of a reporter.

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  7. 7. rickilewis 10:57 am 11/9/2011

    How ironic that authors Meisel and Karlawish are from Penn! My new book, “The Forever Fix: Gene Therapy and the Boy Who Saved It” (St. Martin’s Press, 2012), tells the entire story of gene therapy through the eyes, literally, of an 8-year-old who became able to see four days after gene therapy at Children’s Hospital of Philadelphia. The wonderful researchers who made it possible, including Jean Bennett, Jim Wilson, Al Maguire, Katherine High and others, fleshed out what I learned from the boy himself. This incredible story happened at the same place that, nine years earlier almost to the day, 18-year-old Jesse Gelsinger died of gene therapy, derailing the entire technology. Truth is indeed stranger than fiction.

    Biomedical science is full of stories, backed up with the sometimes-dry data.

    On another note, one problem in the public’s misunderstanding of science is the misuse of the term “proof.” No such thing in science. We disprove hypotheses, and new data continually change what we thought we knew.

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  8. 8. promytius 11:11 am 11/9/2011

    The TRULY IMPORTANT ISSUES to Americans needs no science anyway, so they can, as Americans, act and speak as they choose; just make sure they know WHERE Beber is, what you just twitted, and who’s boob that is; what else is the American public really ready to absorb? Anecdotal science? In 10 years that’s ALL Science will be – it won’t even deserve the capital S, we’ll all get news and info on our encoder implants and commercials will be interrupted by news only if previously arranged, and – duh, short. We’re all headed to an oblivion called Idiocracy – how dumb can you go and still get a decent textphone?

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  9. 9. annamariaevans 11:32 am 11/9/2011

    Um, no. The reality of the situation is that the public is ignorant when it comes to the topic of science. Period. Ask any random individual on the street a basic science question and more than likely they will not know the answer. Here are three examples. At what temperature does water boil in Fahrenheit? How many atoms make up water? What percentage of the world is covered by water?

    We need to flip this scenario. The public needs more education on the topic of science to understand science which will then foster trust. When you have cretinous beings, such as Michele Bachman and Noelle Nikpour for example, shoving erroneous facts down the American public’s gullets, it creates a war between fact and fiction. Unfortunately, fiction triumphs over fact due the lack of quality education in our public institutions. No wonder America lags in math and science.

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  10. 10. davmi 12:16 pm 11/9/2011

    priddseren, you’ve got to be kidding. Do you REALLY believe that the population is capable of looking into the data themselves? Or even willing to take the time to do so? Or doing so without cherry-picking data that serves their preconceived agenda? Very naive of you. Extremely naive of you. I shake my head in disbelief.

    But I do agree with you that, the primary source of scientific research for the public, namely, the popular media, does deliver a biased viewpoint, and that’s true for BOTH sides of the political coin. And the biased message also depends on the corporation(s) that supports a particular media outlet.

    But just because some research is publicly sponsored, does not by default, mean that the interpretation or presentation of the data from that research is biased. Hopefully, the peer review process eliminates such bias. I have to trust that it does. And I trust the peer review process infinitely more than the average person at home, analyzing the validity of the design of a scientific study and the interpretation of the study’s data.

    As for “proof of human caused global warming is all anectodal and primarily based on computer models not observation,” I guess you’ve missed the ongoing analysis of temperature data and the recent study of 1.6 billion data points that confirmed that the planet is warming (http://www.popsci.com/files/imagecache/article_image_large/articles/Updated_Comparison_10.jpg), and the fact that the one of the first media outlets to make those results public was the Wall Street Journal (http://online.wsj.com/article/SB10001424052970204422404576594872796327348.html).

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  11. 11. ASHIK 12:38 pm 11/9/2011

    I think there must be stories of doctors healing cancers or other illness.That means that science has gained public satisfaction.Science and public interactions leading to health benifits must be made at less expence as possible.

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  12. 12. SkepticalKen 10:49 pm 11/9/2011

    I think Science would hurt its credibility by resorting to anecdotal evidence. The range of scientific understanding in the general public is a lot broader and more varied than research scientists on one hand and morons on the other. People who know even a bit of the scientific method might write scientists off for good if they see scientists using testimonials to support their claims.

    What scientists need most is to admit that having a PHD and following the scientific method does not guarantee perfect and/or unassailable results. I have a friend who has colitis. He recently saw a study which had determined that there is NO correlation between diet and colitis attacks. Yet if you talk to any colitis sufferrer, they wil be able to name a food which they don’t dare eat, because it sets off their colitis. Talk to enough of them, and you’ll also find that it’s not the same food for all of them. My friend can eat popcorn and never have trouble, some are guaranteed an attack if they eat the stuff.

    You don’t need much science background to see the hole in the research he quoted. Since different patients react to different foods, NO food they tested was statistically likely to cause symptoms across the whole group, so they “PROVED” that there is no correlation between food and symptoms.

    Now, let’s add in the propensity of scientists (or, perhaps more often, science journalists) to see correlation and call it causality, or to see correlation, not because it exists, but because it can be milked out of the numbers if you jack them around enough.

    Now, let’s add in the fact that scientists do not always agree on everything, that in some cases to intelligent, educated, qualified people can look at the same data and reach different conclusions. That is not always the case, but it is also possible for one to say the data is flawless and another to say it is junk.

    Now, let’s complicate all of that with competition for limited funds, personal and political agendas and good old fashioned hubris. I’m not saying that all scientists are compromised by these things, but I’d be a moron if I said NONE of them are.

    Now, let’s multiply all of that by the tendency of many scientists to think that everyone, everywhere should heed the lessons so obvious in the scientist’s work, and thereby benefit from it, and to think that because it is logical, it must be easy to implement.

    Finally take all of the above and raise it to the power of scientists calling anyone who doesn’t fall in lockstep with them morons, idiots, or the evil puppets of some political or social group. Read the comments on any article on a controversial subject here on SciAm and you will see people on both sides say things that boil down to, “Oh, you believe A, therefore you also believe B and C, are motivated by D and are a sock puppet for E!”

    Granted, this applies to those who attack science as well as those who support it, but when you claim to represent the rational, reasoning, intelligent side of an argument, statements following the above form can only sink your ship! No matter how bad, false or otherwise flawed idea A is, the balance of the statement is that of a raving mainiac. A rational mind MUST know and admit that I may doubt B, think C is stupid, find D revolting and not even know who E is.

    Compelling stories won’t fix any of that.

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  13. 13. SkepticalKen 11:00 pm 11/9/2011

    More thoughts…
    Medical researchers (yes, I already knocked them in my previous comment) probably do more harm to the credibility of Science than any other field.

    Coffee causes cancer. No wait, it prevents cancer.

    McDonald’s food causes obesity. Never mind the FACT that MILLIONS of kids eat the crap several times a week and are skinny as rails. My son is one of those. He’s almost 21 and NEVER been fat.

    And then, my personal favorite, the BEST medicine for asthma is also the LEADING CAUSE OF ASTHMA RELATED DEATH!!!!! Oh, well, if you’re dead, your asthma is gone forever!

    Yeah, give me a compelling story that will restore my faith in THAT!

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  14. 14. SkepticalKen 11:15 pm 11/9/2011

    The world is not a black and white place. It’s not even thousands of shades of grey, though that is closer. No, the world is filled with millions of colors, so don’t try to cram black and white answers down my throat.

    One size does not fit all. What’s good for the goose is NOT always good for the gander unless the gander is gay. (Not that there’s anything WRONG with that!) One man’s pleasure IS another man’s poison, and, presumably, a third man’s “So what?”

    Yes, I’m still railing on medical science. Mostly. Other branches of science should still take notes.
    You are not immune to the same problems.

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  15. 15. collettedesmaris 4:04 am 11/10/2011

    Ms. Harmon – from my perspective, I think that perhaps you’re posing the wrong question. It is not the Scientist who held the responsibility of informing the
    49-year-old mother with breast cancer about it; nor the 60-year-old neighbor with a prostate tumor. Was it not the individual’s Physician who bore that responsibility; not a Scientist?

    A “scientist” is a scientific investigator, and they do not practice medicine. You even refer to a quote from the “Journal of the American Medical Association”, which is dedicated to Physicians & Surgeons – not Scientists. What were you thinking?

    But, Ms. Harmon – the part of your article that REALLY threw up a red flag, was your statement: “Compelling stories could also help counter unwarranted fears about childhood vaccines, by telling the tale of one of the many unvaccinated children who got measles because parents were worried about the purported link to autism.”
    I don’t know where you got the information that you use to compile this “story”, but it is abundantly clear that you didn’t do your homework. How dare you suggest – no, how dare you STATE that the fears about
    childhood vaccines are unwarranted? How dare you! You
    refer to the “many” children who got measles – what defense do you have regarding the 90 Million children who were given SV40-Contaminated Polio Vaccines? And, the Simian Virus was numbered “#40″, because it was the fortieth virus found in those vaccinations! It’s just that the SV40 is the one that has received the most focus because it has been proven to be a Cancer-Causing virus. When a female biologist discovered the existence of SV40 in the vaccines, the government & the pharmaceutical manufacturers of the vaccine put a tight lid on the information, and continued to administer the contaminated stockpile of vaccines for years afterward. I have conducted an extraordinary amount of research on this subject because I was an
    unfortunate recipient of the contaminated polio vaccine. If you think that MY fears about ANY vaccine are unwarranted, then there’s something wrong with the way you think.

    It escapes me how you claim to be a professional reporter covering health, medicine, neuroscience and general life sciences for this publication, and have no awareness whatsoever about the contaminated polio vaccines. For, if you did have knowledge of such a disastrous project, you could not, in all good conscious, refer to people’s fears of vaccines as being “unwarranted.”

    Professional integrity is the cornerstone of a journalist’s credibility. Public enlightenment is the forerunner of justice and the foundation of democracy. The duty of the journalist is to further those ends by seeking truth and providing a fair and comprehensive account of events and issues. Conscientious, ethical journalists from all media and specialties strive to serve the public with thoroughness and honesty. That said, it would unarguably behoove you to do your legwork before you make such a glaring and critically serious error in another one of your articles.

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  16. 16. sault 6:40 am 11/10/2011

    Here you go again pridd…

    What part of the FACT that CO2 traps heat do you not understand?

    What part of the FACT that we’ve increased it’s concentration in the atmosphere by 40% do you not understand?

    What part of the FACT that even though the increase is 100ppm, over 99% of the gas in Earth’s atmosphere is TRANSPARENT to the longwave radiation that the Earth re-emits and that CO2 absorbs? You still have NEVER addressed what you think of 100ppm of arsenic in a glass of your drinking water would do or 100ppm of cyanide in the air inside your house would do, have you?

    I really think your problem is that you utterly believe that government is bad. It is a fundamental part of your worldview that government can do nothing right. Well, how about the Internet, or the Interstate Highway System, or the Apollo moon landings, or stopping Ozone Layer depletion via the Montreal Protocol, or keeping Lake Erie from periodically catching on fire via the Clean Water Act, or getting lead out of gasoline, or how about making automakers install seat belts and catalytic converters? Private industry would never have done ANY of these things, but they still provide a tremendous public benefit. (As for leaded gasoline, seat belts and catalytic converters, the automakers had to be FORCED to implement them!)

    The thing is, you CANNOT point to everything the government does and say it is inherently bad. The evidence doesn’t back you up while there is plenty of evidence of malfeasance in the private sector. For example, see why Ford didn’t recall the Pinto or how the tobacco companies KNEW about the dangers of lung cancer associated with their product but didn’t tell anybody or how predatory lending and credit default swaps led to the financial collapse of 2008.

    Despite my examples, I firmly believe that a lot of good still comes from the private sector. I’m sure you have examples of government ineptitude as well. However, you are the only one issuing blanket statements as if you posses 100% of the facts on every issue when we all know that’s impossible.

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  17. 17. Jerzy New 9:14 am 11/10/2011

    @Author
    No, I think science needs more discoveries that really matter to foster public trust.

    When a doctor selling real medicine is angry at a charlatan selling snake oil, the way is NOT that the doctor dresses like snake oil salesman.

    The problem begins, of course, when doctor’s medicine is no better than snake oil…

    I think the problem is lack of new breakthrough discoveries in science. New medicines don’t offer more than few months of improvement, space program is halted etc. American public in early 20. century was even less educated than today – but they watched landing on the Moon, supported fight with malaria etc.

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  18. 18. Joseph2009 2:57 pm 11/10/2011

    I agree with the doctors at Penn. Scientists in general too often wear the cloak of so-called objectivity. As indicated by annamariaevans above, the alternative to public education in science by scientists could be even more public ignorance in science by political right-wing agents who have the financial wherewithal to buy plenty of media time. Too bad that more of America’s viewing public doesn’t tune in to programs like PBS’s NOVA, instead of preferring commercial TV sitcoms and crime dramas. I recently learned that the PBS program Cosmos a few years ago was one of the most viewed TV programs ever. Yet, I also remember hearing of criticism of Cosmos by some in the scientific community regarding the “popularizing” of science. If I’m not mistaken, even Rachel Carson was subjected to the charge. I would rather see more “popularizing” by scientists than by the global-warming deniers, medical quacks, gun-rights advocates, religious zealots and their short-sighted political supporters.

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  19. 19. Dredd 7:03 pm 11/10/2011

    “Trust” sounds a bit like “faith”, both of which are irrelevant to science in the ultimate sense.

    At least to the extent that science is composed of all things provable.

    It does not matter that truth is stranger than fiction, so don’t bother trying to apologize for strange truth.

    http://powertoxins.blogspot.com/2011/10/are-toxins-of-power-machines-or.html

    Just make sure it is provable.

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  20. 20. Jerzy New 11:34 am 11/11/2011

    @dredd
    Good point. Public shouldn’t ‘trust’ science. Public needs to be educated how scientific method finds truth – precisely so that Joe Public can think for himself and needs not blind trust, which can be abused.

    BTW, American public learns lots of sh*t in their poor public schools – but I think basics of scientific method, objectivity, blind testing are so simple that everybody can learn it.

    Especially that people generally learn very fast if you show them value – checking quality of advertisements, purchases etc. Scientific method is not just about grand and impractical things.

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  21. 21. Carolyn Thomas 12:36 pm 11/11/2011

    Welcome to the wonderful world of marketing-based medicine…

    Every experienced public speaker knows that the basic rule of persuasion is to tell a good story. We’ll forget all those stats that experts tell us, but we’ll retain a good story forever.

    And when stats are all that scientists provide, we’ll then rely on the interpretive bias of those writing the conclusions – and as we know, conclusions can fall victim to things like data fishing or selective outcome reporting. Consider Dr. Isabelle Boutron’s study that suggested 33% of clinical study abstracts contained a “high level” of PR spin, defined as “no acknowledgement of the negative primary outcome, no expression of uncertainty, and no recommendation to study the issue further in another trial.” (See also: “Putting a Positive Spin on Negative Medical Research Results” at http://ethicalnag.org/2010/12/14/positive-spin-negative-medical-research-results/ Then throw in duelling conclusions from two different scientific papers (‘This drug is great! No, wait a minute, it’s dangerous!’) and you have a scenario that can keep those at ‘Retraction Watch’ busy all day long.

    Or, in the immortal words of New York Times journalist Andrew C. Revkin, author of ‘Global Warming: Understanding the Forecast’:

    “For every PhD, there is an equal and opposite PhD!”

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  22. 22. snoozepatrol 12:22 am 11/14/2011

    I think that this article raises a very good point, but many of the commenters also make it clear that “scientific anecdotes” can be problematic. Even sources viewed as respectable and intelligent like NPR and (of course) Ted Talks can simplify science to a point where it can no longer be recognized. I think that in general society does reserve a certain amount of respect for “science,” and it is the responsibility of scientists to keep this respect and present the public with the latest research in accessible ways. One need only look to Bill Nye to see that science can be presented in a very accessible format without losing any of its power or fact.

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  23. 23. boyah 1:41 am 11/14/2011

    Once you have that “degree” one typically has the
    “must be pretty friggen smart” attitude. Or when
    ph deed, one must NEVER stray outside of the text
    taught diagnosis or categorization, why , when if
    not in the book it just does not exist! Such is the narrow and arrogant and ignorant thought that has filled learneed man thru out history! So vain and insecure.

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  24. 24. profchuck 8:08 pm 11/14/2011

    Sadly much of science is funded by politically inspired largess. As a result many scientists exhibit “negotiable” objectivity when it comes to politically popular or unpopular research and findings. As mentioned in a previous response anthropogenic climate change is an example. The problem is that the political capital that can be gained by being on “the right side” of this discussion is enormous. I am very dubious when scientific findings are aligned so perfectly with political objectives. “Political science” is an oxymoron but the benefits of political support are so great that many are willing to leave their scientific ethics at the door. Well heeled science is not necessarily good science.

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