Just the Facts: Effective Medical
& Health Reporting Made Easy
The Do's and Don't of Medical/Health Reporting
By Guenther Krueger
Communicating health information is a specialized and complicated
task, whether the audience is the public or the professional. Information
comes from a variety of sources and is reported in many ways. How
the information is presented and which aspects are highlighted become
important determinants of the story's interpretation.
Media stories tend to have a feeling of authority and permanence
to them, making people react negatively, even with hostility, when
there are errors. This is particularly the case for health-care
professionals who view sloppy reporting with disdain. When the Globe
and Mail has as its headline, "Fatal viruses return with
a vengeance," we might forgive the hackneyed combative style.
However, the first line which states, "They're back. Cholera,
malaria, tuberculosis..." is misleading, since not one of these
three diseases is caused by a bacterium.What else is incorrect in
the story to come?
Learning to report in as accurate and responsible a manner as possible
is an ongoing process. Here are some tips and tricks I've learned
that can help you get it right.
Keep your audience in mind
If you are writing for professionals, you can assume a general level
of knowledge and background. However, if the story is for the public,
aim for clarity and an explanation of terminology that is necessary
towards understanding the key issues. Photographs, charts, diagrams,
pull-outs and sidebars can often go a long way towards helping people
interpret complex theories.
Ask the right person the right questions
If at all possible, ask your questions of the researcher who has
conducted the study, or presented the findings. Frequently these
days, PR people will handle the media giving the story an instant
spin or veneer. My experience is that while scientists may be objective
and more cautious about extrapolating the results, PR people are
much less so and may try to place an inappropriate "breakthrough"
or "breaking news" slant on the story.
Key questions include the following:
"Why was this area chosen for study?" "Why now?"
"What did you find and what does that mean for clinical practice?"
"What does it mean in terms of implications for further research?"
"How does this fit into the overall scheme of research in this
area?" "Who funded the work?"
When you are out of your depth...
In an ideal world we would all understand exactly what experts tell
us, we would formulate the right questions and probe appropriately
in order to shape the story into a model of clarity and thoughtfulness.
In reality of course, we sometimes drown in technical jargon and
the strange intricacies of basic science research findings.
Keep in mind that often the best person to synthesize the results
of studies is the person that conducted the study. Research and
peer-reviewed journals demand a certain level of jargon. You on
the other hand can aim for clarity and even simplicity. Some appropriate
questions to ask of researchers include:
"What is the take-home message here?" "What are
the implications for busy family physicians?" "Where does
this fit into the existing treatment arsenal?" "Does it
replace conventional treatments?" "Augment them?"
"Or is it all too preliminary to tell?"
Aim for a logical flow and above all, clarity
If you don't understand it, neither will the reader. If it's fuzzy
to you, it will be unclear for your audience. If there is a break
in logic, others will have difficulty following your argument. Attempt
to be clear without being patronizing, explain without being pedantic,
and logical without being tedious.
Always keep in mind that disease causation is complex
How people become ill is not nearly as well understood as people
generally believe. Someone sneezing in a room will release millions
and millions of disease-causing organisms and only one person will
become ill. Why?
Disease is caused by a range of factors. These include:
Genetic predisposition or heredity; Socio-economic factors; Strength
of the immune system; Diet; Lifestyle factors such as drinking,
smoking, getting enough rest; Exposure to viruses, bacteria, parasites;
Age, sex; Psychological variables.
These and many other factors come together to make you ill or well,
healthy or unhealthy. Simple, single causes are unusual but rather
fit into a larger whole. Healthy people don't do one thing right,
they do many things correctly. Unhealthy people often practice a
wide variety of inappropriate things that contribute to their disease.
Be careful with extrapolation
It seems that everything these days is groundbreaking and innovative.
Some of it may be, but the vast majority of research moves knowledge
forward incrementally. The "Salk vaccine" days- when one
important discovery could literally wipe out a disease entity -
are long gone. Because new knowledge and understanding happens slowly
and unevenly, the projected path of actual clinical application
is also bumpy and somewhat unpredictable. So, even though editors
and the public may demand simple solutions, the journalist should
resist giving them unless there is very clear evidence for them.
Many times, research findings will alter the "risk balance"
of health in certain individuals. Lowering your cholesterol won't
necessarily make you live longer (although it's possible). What
it will do is lower your risk for cardiovascular complications,
causing you to stay healthy longer and thereby increasing your chances
of longer life. Continuing to smoke won't kill you (although again,
it's possible), but it will greatly increase your chances of all
kinds of harmful effects which will increase your chances of contracting
a range of diseases.
Risk is tricky to understand and interpret. While people want the
shortest possible distance between cause and effect, responsible
journalism will attempt to explain it more in terms of risk/benefit.
Improve your knowledge and your tools of the trade
There are certain things with which you should be familiar, if you're
going to do any health-care reporting at all.
You should be familiar with the scientific approach by which a
problem is defined, a hypothesis or question is raised, deductive
reasoning is applied, the hypothesis is tested through collection
and analysis of data, and finally, the hypothesis is confirmed or
You should understand the clinical trial process, the scientific
way in which agents or procedures are tested to ensure safety and
effectiveness. Methods are compared, often using a placebo or sham
treatment that makes objective measurements possible. There is also
a phase process where, for example, pharmaceuticals move from the
laboratory, into animals, then into selected individuals, and finally
into widespread use.
The more you understand about research design, the more comfortable
you will be in looking at scientific studies and analyzing where
potential problems might arise. Of course, few of us have the background
and expertise to determine whether appropriate statistical inferences
were made and whether the general study design is robust and well-constructed.
Even professional hire statisticians to do the number crunching.
However, you should be familiar with two terms: validity and reliability.
Validity refers to the extent to which the study measured what it
was supposed to. Reliability refers to whether the measuring device
is consistent in measuring whatever it measures.
There are many interesting and informative Internet sites that
explore all of the above-mentioned processes and concepts. As a
good journalist, you shouldn't have any trouble finding them.
A working knowledge of the principles of medical genetics, a field
that is rapidly becoming a common denominator in many diverse areas,
Avoid the blame game
Every disease and condition usually has some sort of organizational
umbrella or funding mechanism, and every single one of them will
tell you that they are underfunded. While money is of concern to
everyone, statements comparing resource allocation in terms of some
arbitrary numbers or comparing one disease to another, is inflammatory
The pharmaceutical industry
Drug companies go to a great deal of trouble to get the word out
about their products. Their influence is pervasive and it's useful
for journalists to have little warning flags pop up when the information
comes from a pharmaceutical company. While the information need
not be invalid, it only stands to reason that there is an agenda
and a spin that will favour the product or the company.
How companies promote their products and influence consumer and
physician decision-making is a complex and controversial area. The
more you understand about the process the better you will be able
to navigate through the minefields of company-sponsored bumf.
Pharmaceutical companies are masters of the advertorial. Selected
scientific studies, presented by high-ranking researchers in professional
forums with carefully-invited and selected participants can provide
a very subjective environment for a product.
All that said, few advances have had such an impact on the quality
of life in Western culture as the introduction of pharmaceutical
agents. And of course, they are costly to produce and require a
free-market economy in which to thrive.
Alternative therapies and products
The area of complementary medicine usually has a built-in polarization
that can be troublesome or provocative depending on your point of
view. Often the differences in approach and opinion are related
to the scientific methods and the way in which anecdotal evidence
takes the place of rigorous research.
None of this is good or bad, but it does require special challenges.
My advice is to avoid those topics you consider flaky altogether.
Build up your personal reference library
Of course there is a great deal of useful information on the Internet.
But it still can't take the place of some good reference books.
To get you started:
Stedman's Medical Dictionary, 26th Edition A great overall
book that I use almost daily.
Medical English Usage and Abusage by Edith Schwager Published
by Oryx Press, this reference is guaranteed to improve your grammar
A medical spell-checker is very useful for your word processor.
Several are available
Anatomy and physiology CD ROMs may be useful to brush up on these
The American Medical Association Encyclopedia of Medicine
A good reference presented in lay terms. Not particularly comprehensive,
but sometimes a good starting point when you know nothing about
a disease or problem.
Pharmaceutical reference books. There are many, and many people
have a copy of CPS. However, I recommend going through the nursing
section at the health sciences bookshop and browsing through several
before you choose. Often these texts have useful patient teaching
information that can be useful when writing a story.
Feel free to contact me if you have further questions: Guenther
Krueger, E-mail: firstname.lastname@example.org
Published in Sources,
Number 45, Winter 2000.
Writing for Daily Newspapers
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Street, Suite 201, Toronto, ON M6G 1L9.
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