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Research may be exaggerated on its way to press

Although most people don't care to read medical journals or attend scientific meetings, they are eager for the latest medical news. So they watch television, listen to the radio, and read newspapers and magazines to stay informed about health.

Usually it's the media that gets blamed when news about medical advances is exaggerated. But two Dartmouth researchers recently made a startling claim: the scientific community may be partly to blame for hyping medical news.

In two studies published in the Journal of the American Medical Association (JAMA), Lisa Schwartz, M.D., and Steven Woloshin, M.D., revealed flaws in the way medical research is reported. In one article, the wifeand- husband team pointed out how press releases from medical journals may exaggerate study results and fail to illuminate their limitations. In the other, they described how preliminary research presentations at scientific meetings may receive unwarranted media coverage.

General press: "Since so much of what people know and believe comes from the general press, we thought it would be important to look at how medical research is covered," says Woloshin. He and Schwartz, who are part of the Outcomes Group at the VA Medical Center in White River Junction, Vt., have made a specialty out of exploring how medical information is communicated to the public.

Steve Woloshin and Lisa Schwartz read health news in the paper with an even more discriminating eye than do most doctors. They recently published two studies in the Journal of the American Medical Association putting some of the blame for exaggerated coverage of breaking medical news onto the scientific community.
Image: Flying Squirrel Graphics

Although medical journals strive to ensure accuracy in the papers they publish, their press releases do not always reflect those efforts, say Schwartz and Woloshin. Some press releases may exaggerate the perceived importance of findings, may not highlight study limitations or industry funding, or may not present numbers very well.

The researchers conducted 15-minute telephone interviews with press officers at nine prominent medical journals and analyzed 127 press releases about research articles. Seven of the nine journals routinely issue press releases: Annals of Internal Medicine, British Medical Journal, Circulation, JAMA, Journal of the National Cancer Institute, Lancet, and Pediatrics. Annals of Surgery and New England Journal of Medicine do not.

Haphazard: "What we found was a haphazard process" in the way the journals issue releases, says Woloshin. "Some have very little editorial input" other than to select the articles that will get press releases. "At the other end of the spectrum is the Journal of the National Cancer Institute," where the study author, the editor who worked with the author, the journal's editor-in-chief, and the press office work together "to really make sure that the thing is done right."

In addition, says Schwartz, "some people are writing very short tips for the media and then there's the longer one- or twopage press release."

She and Woloshin believe that the quality of press releases could be improved if the journals strengthened the editorial oversight of the process and developed a standard format, analogous to the structured abstracts that summarize a study.

Meetings: In their other study, Schwartz and Woloshin elucidated how press coverage of scientific meetings may be "too much, too soon."

"We've noticed in the newspapers that medical meetings get a lot of coverage," says Woloshin. "The stuff that gets picked up by the media is most likely to affect the public perception." Often those studies are preliminary and may not live up to their early promise. But the public rarely hears if the research doesn't pan out as hoped.

The authors looked at media coverage of five high-profile medical meetings in 1998 and found 252 news stories reporting on 147 research presentations— an average of 50 news stories per meeting. Only 50% of the presentations were later published in high-impact journals; 25% were never published and 25% were published in low-impact journals.

Interestingly, "if your abstract got a press release, you were more likely to get page one [media coverage, but] slightly less likely to be published in a high-impact journal," says Woloshin.

Schwartz and Woloshin are quick to point out limitations in their own work. In the press release study, for example, they examined only a few journals and a limited number of releases and did not assess the relationship between the releases and subsequent media coverage. For the scientific meeting study, they did not examine the extent to which the public pays attention to or is influenced by such stories.

They are planning follow-up research, including a content analysis of the news stories.

Laura Stephenson Carter

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