http://society.guardian.co.uk/publichealth/story/0,11098,664231,00.html
A healthy challenge to
the media
A new NHS body is challenging
inaccurate health stories but a study shows the boom in internet health sites
means it faces an uphill struggle. Michael Cross reports
Friday March 8, 2002
Good news for healthy breakfasters. On the same day last month, the Daily
Express and the Sun both reported that starting the day with high-fibre cereal
can make you happier and more energetic.
But the newspaper reports didn't tell the whole story - not surprisingly, as
the Sun's was only a single sentence. According to reviewers at the NHS centre
for reviews and dissemination, the articles misleadingly reported findings of a
research study which itself had weaknesses in methodology.
Some of the research conclusions were "based on poor quality evidence and
should be interpreted with caution", the reviewers concluded.
Although the scientists used "a reasonably well-conducted randomised
controlled trial their findings relied on participants filling in questionnaires
about fatigue and digestive symptoms". Such outcomes are "very subjective and
could be subject to bias", the reviewers said.
They also pointed out that the study was sponsored by the Kellogg company,
maker of All Bran.
The breakfast cereal study is one of the latest pieces of research to come
under the scrutiny of the centre for reviews and dissemination's 'hitting the
headlines' service.
Unsurprisingly, hitting the headlines pulled out all the stops for the MMR
debate. It ran a two-part critique of articles in the Guardian, the Daily
Telegraph and the Times summarising research into the vaccine, autism and bowel
disease.
The broadsheets get some credit for accuracy: the Guardian reported a large
study showing no increased risk of autism after the MMR jab "briefly but
accurately".
An earlier investigation, however, is critical of the Daily Mail's coverage
of links between the measles virus and bowel disease. "The Daily Mail
misleadingly reports that the children in the study were autistic and focuses
the rest of the report on the MMR vaccine," it concludes.
The centre's reports appear at the rate of one or two a week on the web front
page of the national electronic library for health, run by the NHS information
authority.
This week, the authority approved funding of £67,548 for the service, which
has been running as a pilot, to continue until the end of March 2003.
The team behind hitting the headlines does not see itself as part of the NHS
spin machine. It investigates articles based on published research into the
effectiveness of medical interventions or diagnostic tests; the sort of stories
that appear under headlines suggesting either a miracle cure or a new health
scare.
"We investigate the type of article that worried patients might take along to
GP surgeries," said Alison Booth, dissemination officer at the centre, which is
based at the University of York.
The centre concentrates on articles that appear in more than one newspaper
and which are based on research that it can scrutinise.
"We identify a story that fits the remit and get hold of the published
research," Ms Booth said. Independent reviewers then appraise the research and
the way it is portrayed in the article.
The result of the investigation appears as a bullet-point summary and a more
detailed critique within days of the original coverage. "We aim at a 48-hour
turnaround, but that depends on getting hold of the journals," Ms Booth said.
This can be difficult in the case of more obscure publications. "We go to
extraordinary lengths to get hold of the original research," she said.
Perhaps surprisingly, the fourth estate comes out reasonably well from the
centre's scrutiny. "The article is usually reasonably accurate," Ms Booth said,
"the problem is more often in the headline on top."
Monitoring the quality of health information in the mass media was one of the
main reasons for setting up the national electronic library for health (NeLH),
which was conceived in 1998 and has been running as a pilot project for just
over a year.
However the NeLH is still waiting for the Treasury to approve the business
case for a full-blown service. This is now not expected until 2003, an NHS
information authority spokesperson said.
In a related initiative, the Centre for Health Information Quality, based at
the Help for Health Trust in Winchester, is developing a seal of approval,
called the TriangleMark, to show where information meets its standards. Its
funding stream, however, is still uncertain: the centre is hoping that the
TriangleMark will be self-funding.
However research published this week suggests that, if the NHS is seeking to
rid the web of inaccurate health information, it faces an uphill task.
A study of 121 health websites reported in this week's British Medical
Journal finds that only 49% displayed the date when the information was put on
the site, and 82% did not show the relevance or validity of it.
The five topics looked at were chronic obstructive pulmonary disease, ankle
sprain, emergency contraception, menorrhagia (abnormally heavy menstrual
bleeding) and female contraception.
Lead author Khalid Khan, a consultant at Birmingham Women's Hospital's
education resource centre, said: "Our study shows that features of website
credibility have only slight or, at best, moderate correlation with accuracy of
information in five common health topics."
The British Medical Journal advises patients using the internet to
double-check all information found and use the internet to supplement
face-to-face meetings with a doctor.
Related articles
08.01.2002:
Anne Karpf : Their risks - and ours
27.12.2001:
Pro-smoking campaigner scoffs at health scares
06.02.2002:
Blair attacks MMR 'scaremongers'
06.02.2002:
Q&A: measles and MMR
15.06.2001:
Study
'refutes' MMR link to autism
Big issue
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