Recommendations for journalists

1.     Read everything you can at the HealthNewsReview (HNR) website

2.     Utilize the HNR toolbox

3.     Interview experts on The List of Industry Independent Experts  

4.     Take courses in epidemiology/methodology – understand the science of medical studies and what they can and can’t demonstrate

5.     Don’t assume that the physician leaders of major professional organizations like the American Heart Association or the American Lung Association are necessarily accurate or unbiased. Professional organizations often take substantial funding from industry (pharmaceutical and device companies, hospitals and contract research organizations)

6.     Although it is true that not every issue “has two sides” (diabetes can be treated with insulin – no argument; asthma improves with beta agonists, etc.) yet it is important to question a good deal of what is accepted as true in medicine. Cultivate respected critics who can explain science clearly and why received wisdom may be inaccurate.

7.     Study, study, study: learn why a drug that reduces disease progression in cancer may not be a good thing; understand why surrogate markers so often fail, learn the many different types of studies in the research pyramid and their limitations; learn about the counterintuitive problem of “catching things early” with screening tests, learn not just false positives and false negative test results, but understand them in terms of predictive values and how incidence rates can dramatically alter the value of even highly accurate tests.   

8.     Remember, medical “science” is often rooted not in actual science but in blind faith and imperfectly recalled or misunderstood experience. The “latest advances” will often be overturned and found to be less than helpful. See Vinay Prasad’s book: Ending Medical Reversals. New technology is not always best technology.

9.     Always seek to understand what financial conflicts of interest may be at play in every article you write. Learn how financial conflicts are very different in their effect from other forms of bias. (The key here is that financial conflicts are almost always unidirectional – favoring sponsored interventions and distorting the body of scientific evidence) while personal biases or values are generally multidirectional (one person favoring a certain intervention while another may think it a bad not), which doesn’t necessarily impact the body of evidence and can lead to clarification through conflict. See: When is a point of view a conflict of interest?

10.  Strive to be and to do what is expected of scientists: test your own hypotheses and be open to being wrong. Go where the evidence leads you, even (or especially) when it strains your own beliefs. The best advice I received came from a medical researcher who urged me to do what good scientists must do: always try to prove myself wrong. Thanks to that advice, I go over my articles in the draft stage and pretend to read it as an adversary. I look for weak spots and attack what I’ve written. The result is that sometimes I’ve had to strengthen what I’ve written – but sometimes I’ve found that I overstated or even contradicted the evidence I’ve cited, and I’ve been forced to rethink what I perceived to be true.