Media Management Of Women's Health
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How Do You Assess the Medical Information You Hear or Read?

Interestingly, the first step to judging the quality of a medical news or feature story uses the same criteria for judging any journalistic coverage:  does it correctly answer the who, what, when, where, how, and why of the issue?  In addition, here are ten tips to evaluate media coverage of health and medical information.

Top ten tips for evaluating media medical information:

1. Consider the primary source: confirm that the news is coming from a reputable medical organization (e.g. American Medical Women's Association, the SAWHR, the American College of Obstetricians and Gynecologists, etc.), publication (e.g. the Journal of Women's Health, the New England Journal of Medicine, the Journal of the American Medical Association), physician, or institution.
   
   
2. Consider the secondary source: who is the spokesperson or reporter who gave the information? Is this a news, entertainment or medical reporter?  Is this someone with a good track record?  Is the spokesperson a credible physician?  Often, media personalities who refer to themselves as "Doctor" actually have a doctorate (PhD) in subjects as diverse as psychology, exercise physiology, meteorology, or education. . .but they are not physicians.  Many times you may hear medical information from an author whose credentials come from having researched and written an article or a book.  Celebrities are popular spokespeople for diseases and treatments.  Ask if the celebrity spokesperson is actually speaking about their own personal experience or are they simply reading a script?  Do they really use the product they are promoting?  Does that really matter to you?--and more importantly, is it relevant?  Celebrity spokespeople serve a valuable role raising awareness about (and research funding for) medical problems and sharing their  experiences.  They should not be making medical recommendations, however.  In fact, the best use of a celebrity spokesperson is when they are partnered with physicians.
   
   
3. Is the information presented in a balanced way?  A well balanced report will mention side effects of medications (they all have side effects, even the so-called "natural" remedies), treatment options, diagnostic choices, or will give different opinions from several credible sources.  Remember, however, that time is always quite limited on television and radio. . .sometimes physicians are interviewed for an hour and all that is shown is a 30 second sound-bite. Why do we always emphasize (sometimes twice) that you must see your doctor if you think you have whatever condition we are discussing?  Because that is the most important fact of any health story.
   
   
4. Read the "fine print" carefully; be sure the information applies to you.  For example, many menopausal women were recently concerned about reports of the HERS study evaluating the role of estrogen in preventing heart attacks in women who already had pre-existing heart disease and a previous heart attack.  The last 10 words of that sentence didn't make it into most print or broadcast coverage, causing needless anxiety for patients and confusion for many physicians.  Most people are not aware that physicians hear or read "the news" the same way and at the same time as the general public.  Many times the media reports of a medical journal paper come out before subscribers receive their journals. . .and I have yet to meet any physicians who can read their journals cover to cover the day they arrive.



5. Consider the weight of previous studies.  Does the current study support or refute previous research?  If two studies conflict, is there a discussion offered as to why that might be?  When this happens, how do we know which one to believe?  (see section on statistics, below).  Could it be, perhaps, that the study reported in the news is a "juicier" story than the conflicting ones?  (i.e. did that study show an association between a particular intervention and a negative outcome that was not found by the previous literature?)



6. What kind of study was this?  Was it a survey or an actual clinical trial?  Was it observational? Was it randomized, "blinded" or placebo-controlled?  Was there a separate control group?  When hearing different statistical results, learn to listen like a pro and ask "were these results 'statistically significant'?"  (i.e. once all the relevant numbers are crunched, do any differences in the groups studied really reflect true differences?). Was the study large enough to have significant "power"?  (again addresses the issue of statistical significance).  Most importantly, does the appropriate expert discussing the data think that these results will be "clinically significant"?  That means that when this particular regimen is practiced in the general population, will it really make a difference that doctors can see in their own patients?  A good thorough news report of any medical study will ask and answer these questions for their audience.
   
   

Learn what these terms mean if you really want to understand thoroughly the importance of a medical research article and how it may apply to you and your family.  It is not necessary to know all these differences, however, in order to make informed medical decisions.  The most important factor is to have open communication with your physicians so that you feel confident that the relevant information is being explained to your properly from someone who knows what information is relevant to you.  Benjamin Disraeli once stated that "there are three types of lies:  lies, damned lies, and statistics".  In medicine, appropriate interpretation of statistics is essential for proper application of that study to you.

7. Does the study show cause and effect (e.g. aspirin can cause bleeding ulcers in some people) or was it simply a non-causal association (e.g. the most car accidents in a year occur on the same day that the most ice cream is sold)?  Do the experts agree?  Why not?  Why they disagree is often more important than the fact that they disagree.
   
   
8. If a treatment is being called an "alternative", what is it alternative to?  Why is it an alternative therapy rather than a complementary or mainstream medicine?  Has its safety and effectiveness been established?  Who conducted the studies?  Where?  Has it been reviewed (and approved) by the FDA?  Remember that ALL therapies have side effects and potential interactions with each other.  ..  .this includes alternative therapies and "natural" therapies, as well as prescription and over-the-counter medicines.
   
   
9. Is there a relationship between the media source or medical content and any advertising?  This relationship may be coincidental or influential and occasionally may present a perceived or real conflict of interest.  Sometimes content and advertising can be complimentary (it can refer you to an educational program, for example, or give you important information not in the article); sometimes they can be confusing (such as advertorials-are they ads or articles?); and sometimes they can be downright contradictory in message impact.  The best examples of the latter situation are teen magazines which write about the numerous health problems associated with eating disorders (anorexia and bulimia) while featuring glossy ads with dangerously thin models or articles glorifying popular actresses who are clearly significantly underweight. 

Another example of a serious conflict is in publications that focus on promoting health and beauty, yet which accept cigarette advertising!  Smoking is not healthy, and it is not beautiful.  A hot-off-the-press survey of 21 popular women's magazines published by the peer-reviewed Journal of Women's Health (May 1999) revealed that two-thirds of women's magazines still accept smoking advertisements.  This is unacceptable.  Clearly, young women in particular are influenced by both advertising and fashion content.  As Ms. Mary Ann Liebert, Publisher of this respected medical journal said, "If smoking is perceived as cool and sophisticated, women who smoke feel justified and women who do not yet smoke may decide to do so."  The SAWHR (www.womens-health.org) has championed this issue as an important women's health education initiative and has called for publishers of all women's magazines to stop accepting tobacco advertising aimed specifically at women. Popular women's magazines that do not accept cigarette advertising include:  Brides, Good Housekeeping, New Woman, Seventeen, Shape, Town and Country (although they do accept cigar advertising), Weight Watchers, and W.  Women's magazines that continue to accept cigarette advertising include:  Allure, Cosmopolitan, Vogue, Mademoiselle, Glamour, Harper's Bazaar, Marie Claire, Redbook, Ladies' Home Journal, Mirabella, Jane, Mode, McCalls, and Elle.  Phyllis Greenberger, Executive Director of the SAWHR asks pointedly "How can publications that accept tobacco advertising say they are committed to improving the well-being of women?"  Women need to ask this question of any media where they perceive a disconnect between their advertising policy and their editorial perspective.

10. As with any other subject matter, if something sounds too good to be true, it probably is  (e.g. a miracle weight loss pill without dieting,  exercising, or side effects).  Seek confirmation of the information you hear or read from other reputable information sources.  The most important source is your physician or a specialist to which you may be referred.  Other sources include websites of medical organizations and medical textbooks or journals.