If Only There Were a Fix for the Medical Misinformation Online

(Bloomberg Opinion) -- It’s a fact of life that there’s more trash than treasure, more losing lottery tickets than winners, more bad scientific theories than good ones, and more misinformation than information. When that misinformation concerns health and medicine, it can do a lot of harm.

Researchers have recently been decrying the problem in the pages of the Journal of the American Medical Association, while the social networking site Pinterest has made a move to stem disinformation by refusing to grant search requests on vaccines, which have become the subject of misguided conspiracy theories.

A spokesperson for the company told the Wall Street Journal that this block was a temporary measure while developing a better way to sift through “polluted” content. But the flow of information pollution is as old as language. The problem we face today is that the bad information is getting harder to distinguish from the good, and fewer people are going to the trouble of sorting it out.

The JAMA authors suggest that “cultivation of trust in the medical community” will improve the situation more than debunking the misinformation. This rests on the assumption that the medical community should be trusted. It’s no worse than any other community, but doctors and medical researchers get things wrong often enough.

Attempts to replicate medical research findings have turned up so many questionable results that some critics estimate the bulk of published claims are wrong – a problem known as the replication crisis, which has also clouded social science.

Doctors also follow bad advice and bad standards, perpetuating wrong practices that destroy lives. Right now the focus is on all the death and destruction caused by opioid painkillers, but before that it was the thousands killed by Vioxx, the often debilitating and painful unnecessary treatment of men based on an overrated screening method for prostate cancer, overtreatment of women  for breast cancer, the harms of low-fat dieting, and the use of unsafe medical devices.

The pharmaceutical industry pays billions of dollars for direct-to-consumer ads for drugs that may not work or pose serious side effects. It spends billions more marketing to doctors, including speaking fees and gifts to persuade them to prescribe their drugs. Often, medical researchers and institutions are under pressure to get good publicity before they know whether their therapies are safe and effective, and they pay PR people for promotion.

Journalists have traditionally been watchdogs on the medical industry’s hype machine. In my 16 years at the Philadelphia Inquirer, some detractors claimed we were just in the business of selling newspapers, but that wouldn’t be such a bad thing if it meant pleasing subscribers who paid for publications in order to get a reliable source of information. There was a sense of accountability, and I lived in constant fear – a healthy, productive sort of fear – of getting things wrong.

As recently as the 1990s, nobody would have known what it meant to induce readers to “click” on a story. Now it’s every story for itself, battling for clicks in a swamp of other stories that are, by the nature of things, mostly garbage. I suspected we were in for trouble a few years ago when I taught a college class in science writing and asked the students about stories they saw and shared on Facebook. Most students were enthusiastic story-sharers. For the most part, they never considered whether stories came from a respected, independent news source, an industry-funded think tank or somebody’s blog. The important thing was whether sharing the story would make them look smart, or cool, or interesting.

Gary Schwitzer, who is something of an expert on medical misinformation, agrees that journalists used to do the critical job of sorting good information from bad. For years he ran a website called Health News Review, which evaluated the way medical news was presented in the media. There’s still good information out there, he said, but it’s being drowned out by misinformation.

“There are definite peaks of excellence that represent the best in health and medical journalism, but the valleys are becoming wider and deeper,” he said. The harm that’s done by the “daily drumbeat of dreck,” he said, outweighs the good.

The dreck is often highly sharable. A story about the dangers of childhood vaccines seems a lot more attention-grabbing than a true story saying standard vaccines are still safe. The phrase “cancer cure” is always good for clicks and shares – but trust me, if anyone cures cancer, you’ll see it on the front page of the New York Times, not just in Aunt Clara’s Facebook posts.

Schwitzer said he thinks the health information pollution problem started in the 1980s. That was when public relations people started to influence the news, tempting reporters with easy, uplifting, pre-packaged stories.

It’s just a fact of life that most experimental therapies and drugs won’t pan out. That’s a necessary part of science. The harm arises because much of what is promoted is, as Schwitzer puts it, “not ready for prime time.” These stories often appeal to desperate people, ready to grasp at any sign of hope.

The Health News Review website wasn’t just aimed at policing reporters, Schwitzer said, but at helping the public find good health information and learn to recognize factors that sort the gold from the garbage.

But Health News Review has been discontinued for lack of funding.

The JAMA authors pose this question: “Can the public be taught health literacy to help them discern facts from opinions and falsehoods?” Yes, of course: It not only can be done, but also has been done. But these days it’s hard to find a way to make it pay.

To contact the editor responsible for this story: Philip Gray at philipgray@bloomberg.net

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

Faye Flam is a Bloomberg Opinion columnist. She has written for the Economist, the New York Times, the Washington Post, Psychology Today, Science and other publications. She has a degree in geophysics from the California Institute of Technology.

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