Survival of the Wrongest

David H. Freedman’s ‘Survival of the wrongest’ analyzes the state of health journalism, with the conclusion indicated by the headline. He begins with various articles on obesity which The New York Times had published over the years, all written by experienced journalists and apparently backed by solid science. Nevertheless, they come up with totally different recommendations, contradicting both each other and anecdotal clinical evidence. The field of health journalism at large does not fare much better.

The author of a report based on that survey, Gary Schwitzer, a former University of Minnesota journalism researcher and now publisher of healthcare-journalism watchdog, also conducted a study in 2008 of 500 health-related stories published over a 22-month period in large newspapers. The results suggested that not only has personal-health coverage become invasively and inappropriately ubiquitous, it is of generally questionable quality, with about two-thirds of the articles found to have major flaws. The errors included exaggerating the prevalence and ravages of a disorder, ignoring potential side effects and other downsides to treatments, and failing to discuss alternative treatment options. In the survey, 44 percent of the 256 staff journalists who responded said that their organizations at times base stories almost entirely on press releases. Studies by other researchers have come to similar conclusions.

The culprit is not just sloppy reporting that distorts good science. For a variety of reasons – some specific to the complexity and ethics of medical research, others endemic to the incentives of scientific publishing – even peer-reviewed health studies published in respectable journals tend to be inaccurate.

To cite a few examples out of thousands, studies have found that hormone-replacement therapy is safe and effective, and also that it is dangerous and ineffective; that virtually every vitamin supplement lowers the risk of various diseases, and also that they do nothing for these diseases; that low-carb, high-fat diets are the most effective way to lose weight, and that high-carb, low-fat diets are the most effective way to lose weight; that surgery relieves back pain in most patients, and that back surgery is essentially a sham treatment; that cardiac patients fare better when someone secretly prays for them, and that secret prayer has no effect on cardiac patients. (Yes, these latter studies were undertaken by respected researchers and published in respected journals.)

Health journalism usually ignores these contradictions, and instead builds a deceptively harmonious picture from a handful of cherry-picked findings. Scientists’ PR statements are simply reprinted rather than questioned and analyzed, as in business or political journalism. The result is a systematic bias towards wrongness.

Given that published medical findings are, by the field’s own reckoning, more often wrong than right, a serious problem with health journalism is immediately apparent: A reporter who accurately reports findings is probably transmitting wrong findings. And because the media tend to pick the most exciting findings from journals to pass on to the public, they are in essence picking the worst of the worst. Health journalism, then, is largely based on a principle of survival of the wrongest.

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