Medicine And The Media - More Good Than Harm

A major news service ran a medical story on July 15, 1998 headlined "Ear Crease Linked to Heart Disease in Blacks."

The story stemmed from a study of earlobe creases in 27 men with a history of heart attack and 16 men with no history of heart disease. All 43 men were African-American. Earlobe creases were found in 16 of the men with a history of heart attack and 3 of the men with no history of heart disease.

The news release states that the author noted that: "This is the first study to link this physical characteristic with coronary artery disease in African- Americans." This study was presented at an International Interdisciplinary Conference on Hypertension in Blacks held in Charleston, South Carolina.

These results would appear to suggest that African- American men with creased earlobes are at increased risk for heart attacks, but intuitively the numbers of men in the study seem small. Only 27 men had heart attacks and there were just 16 normal "controls."

Rather than rely on intuition, all of the numbers in the study can be tested. And with an appropriate test (the chi- square test of goodness of fit), the numbers prove to be not statistically significant (chi-square=3.73; P>0.05).

Results that are "not statistically significant" can be all too easily stumbled upon by chance alone. In other words, there is NO meaningful evidence that earlobe creases are associated with heart attacks.

According to the news story, the doctor who presented the work in at the conference in Charleston, and her colleagues are at highly respected medical universities. This, too, would seem to put a seal of authenticity upon the research.

What may not be evident, however, is that medical schools rarely require faculty members to submit for approval even an abstract of the research results they are going to present at a meeting. The academic and hospital affiliations are not a seal of medical science good housekeeping.

This study that claimed to link ear creases and heart disease has also not (to our knowledge) been published in a medical journal after undergoing the careful scrutiny, criticism and approval of other biomedical scientists in the peer review process.

How can medical research of this type be reported by a respected news service? What credentials do medical (and science) reporters have to have?

Brill's Content magazine (August, 1998) lists the schools attended by 13 medical and science reporters working for prominent newspapers and networks. The newspapers include the New York and Los Angeles Times and Washington Post and the networks are ABC, CBS, CNN, Fox and NBC. Only 7 of the 13 reporters have a doctoral degree. Of them, only 5 have an M.D. A chief science reporter for a major network has no advanced degree. A medical reporter for a national newspaper has but a B.A. in English.

One of the most highly educated members of the biomedical media described by Brill's Content is Dr. Timothy Johnson, Medical Editor of ABC News. After medical school, Dr, Johnson returned to school and was awarded an M.P.H. from the Harvard University School of Public Health.

The Shattuck Lecture, a venerable and prestigious lecture, was delivered this year by Dr. Johnson. His talk on the matter of "Medicine and the Media" was published by The New England Journal of Medicine (July 9, 1998).

"By the mid-1980s, medical reports...had become popular features in both print and electronic news media, " he noted. "Both medical scientists and media owners had learned that it was quite good for business to feature health and medical news." "But," he says, "the rush to promote themselves and reach out to the public often caused both medical scientists and journalists to violate some of the sacred tenets of their respective professions."

Johnson gave a dramatic example of the "rush to report" medical news. In 1984 an experimental treatment for Alzheimer's disease was tried. This "preliminary, single- blinded, subjectively assessed experiment involving four patients unleashed a national media feeding frenzy." The treatment "quickly passed into oblivion."

There should be, Johnson holds, "a substantial difference between the reporting of general news and the reporting of medical news." "In contrast to general news, which is based on facts and sources and opinions, medical information is traditionally based on data and probabilities and conclusions." The two are very different and require different kinds of analysis and presentation."

"Unlike the reporting of standard news," Johnson observes, "good medical news reporting requires additional and very specific skills in the understanding of biostatistics and epidemiology." And we would add that other "very specific skills" are useful in medical journalism, skills that are a part of medicine and the biomedical sciences that are the powerful engines of progress in medicine.

Incidentally, it is of interest that there is no certification of medical journalists. As Johnson points out, "there is certainly a precedent for such credentialing in the media in the use of meteorologists to report the weather." Is our weather more important than our health?

Timothy Johnson concludes his remarks on "Medicine and the Media" by confessing, "...I would like to believe that those of us who labor in the vineyard of medical journalist do more good than harm, that we usually provide medical consumers with useful and accurate information that can be used to make important medical decisions about themselves and their loved ones."

We agree with Dr. Johnson's remarks. It is our strong belief that patients and families empowered by basic understanding of medical conditions will be better consumers of healthcare.

Last Editorial Review: 7/22/1998