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Evidence Based Medicine (EBM) and the Illusions of Media

Submitted by on July 1, 2012 – 9:04 PM 4 Comments

When we talk regarding Evidence Based Medicine (EBM) there are two really important things about evidence, first is the output if something is good for you or bad for you and that’s the thing that a lot of people are interested, a lot of doctors are interested and a lot of patients are interested in but there is also a second factor which is how people know, how do you know that something is good for you or bad for you, how would you go about measuring that, there are a lot of situations in which it is important to know that. What’s more interesting today in mainstream media is not that somebody is wrong but how they are wrong. I have a whole lot to share about where media have gone wrong and then about how it affects the society.

Firstly does it matter? If something in the media is correct or incorrect. Well I think it is because the journalists change the publics’ health behavior. The kind of impact depends on what kind of stories they cover such as raising the awareness in Kylies’ breast cancer in United Kingdom (UK) resulted in 40% increase in mammogram bookings. Also the kind of coverage the journalists gets has an impact on changes in the behavior of the public. Journalists change doctors’ and academics’ behavior too such incidences are seen when disease awareness campaigns double prescriptions by doctors.

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However there are some incidences where media has grossly misreported the evidence. Such as the case of Measles, Mumps, Rubella (MMR) vaccine which was reported by journalists in the national newspapers in UK to cause autism. If the disease is of low incidence, it would only be significant if it is caused by a rare exposure but for MMR vaccine which has a very high coverage reporting MMR vaccine to have strong links with autism on the basis of just a published case series is not a good idea. There are examples of similar other vaccine scares which were created by media. Such as if you go to France and tell them about MMR causing autism they would say “Not at all, it’s perfectly fine, everyone gets it, it’s the Hepatitis B vaccine which you should worry about because it causes Multiple Sclerosis (MS). Haven’t you come across the print media?.” Similarly fear of polio vaccine to cause infertility created by local media in Nigeria failed Global Polio eradication program. Another story went on air in United States (US) implicating thiomersal, a vaccine preservative to cause autism without any valid evidence behind it, this fear in public led to the authorities removing thiomersal from the vaccinations. However it was not a problem for US because of its large vaccine distribution chain but for a country like Africa where the vaccines have to be transported to far off areas and may have to be stored for use, preservatives like thiomersal are very necessary and Africans believed in that misreported story linking thiomersal to autism, rejecting it to be used in vaccines just because American authorities took it off from there vaccines.

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Coming on to the evidence that media presents for such stories, most of the times the misreported evidences are based on individual case studies or on the expert opinions from individual doctors. For instance, in the case of MMR vaccine in UK, interesting thing in this case was the selective evidence that was stated in the press considering it to be valid evidence without having concern about the quality of studies. The reported evidence presented by media was two unpublished researches by Krigsman in 2002 and 2006 respectively. On the contrary studies by Afzal 2006, D’souza 2006 showing negative findings were totally ignored and were never reported.

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Similar widespread public fear and distrust of vaccines were also seen in our neighboring country China where scary- news reports linked oral polio vaccine (OPV) with child paralysis. Media coverage of such invalid stories became a nightmare for Chinese leaders and health officials, to the extent that no Chinese leaders’ has dared to take the risk of being pictured giving children the OPV.

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Such vaccine scares and media misreports have also been noticed variably in Pakistan as well. It is only recently that stories have run in local press implicating Central Intelligence Agency (CIA) of running fake polio vaccination program with claims that they plan to ethnic cleanse and sterilize the people of the area. In the first half of the current year, 59 cases of polio are reported in Pakistan.

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The media is the perfect tool for teaching evidence based medicine but the media sometimes tends to extrapolate from the observational things to clinical claims. So how bad is media coverage? Because journalists get the appraisal paradoxically by criticizing the governments and blaming the celebrities but I am not sure how it would go about when it comes to misreporting evidence based medicine.

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The main question now that arises is what level of evidence do journalists and editors regard as newsworthy? The journalists should only report the systemic reviews and high quality large studies while covering stories rather than grounding their stories on individual case reports or expert opinions. It is bad to make the stuff up and mislead the public. More importantly it is unsatisfactory because it undermines the confidence in research and that it undermines the evidence based medicine.

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Considering the “viral” nature of information dissemination in this era of electronic and print media, it should be our duty to identify and rectify information, specially if its pertaining to human health. We should strive to go to the public ourselves to make corrections, blog it, write about it, pod cast it and do it in person!

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About the author: Atif Rasool is a final year Medical student at Sindh Medical College, Dow University of Health Sciences, Karachi, Pakistan. He is actively interested in research and is currently head coordinator of Research and Development Department of Patients Helping Hands, NGO of SMC students. He can be reached [email protected]

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About this article: This article is competing for the JPMS International Medical Writing Contest 2012 for the theme: Medics and Print/Electronic Media. To learn more about the contest and to participate in it, follow this link: http://blogs.jpmsonline.com/writing-contest/

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  • Ali Raza

    gud work Atif :)

    • Atifrasool

      Thanks Ali.. Glad you liked it :)

  • http://www.facebook.com/sidratul.muntaha.1690 Sidra Tul Muntaha

    Nice j0b :)

    • Atifrasool

      Thanks :)