Global Media Coverage of the Benefits and Harms of Early Detection Tests

O’Keeffe, Mary; Barratt, Alexandra; Fabbri, Alice; Zadro, Joshua R; Ferreira, Giovanni E; Sharma, Sweekriti; Moynihan, Ray

doi:10.1001/jamainternmed.2021.0261

Cited by 16 publications

(26 citation statements)

References 6 publications

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“…This sample of Australian journalists seem aware of the potential harms of medical tests such as overdiagnosis, which are often left out of media coverage. 17 But, effectively communicating overdiagnosis is a challenge in light of entrenched beliefs about the benefits of testing and the culture of current journalism practices. Providing journalists with training and support in their efforts to communicate overdiagnosis could aid critical reporting of tests.…”

Section: Discussionmentioning

confidence: 99%

“…The media, through promoting early detection tests to healthy individuals, is considered an important driver. 15 A recent cross-sectional study 17 of global media coverage—including over a thousand media stories about five early detection tests (three-dimensional mammography for breast cancer, liquid biopsy for cancers, Apple Watch for atrial fibrillation, blood biomarker tests and artificial intelligence technology for dementia)—found that the potential benefits of testing were presented far more frequently than potential harms. The risk of overdiagnosis was mentioned in very few stories.…”

Section: Introductionmentioning

confidence: 99%

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Journalists’ views on media coverage of medical tests and overdiagnosis: a qualitative study

et al. 2021

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ObjectivePromotional media coverage of early detection tests is an important driver of overdiagnosis. Following research evidence that global media coverage presents the benefits of testing healthy people far more frequently than harms, and gives little coverage to overdiagnosis, we sought to examine journalists’ views on media reporting of tests, overdiagnosis, and strategies to improve critical reporting on tests.DesignQualitative study using semistructured telephone interviews. Interviews were conducted between February and March 2020 and were audiorecorded and transcribed verbatim. Framework thematic analysis was used to analyse the data.Participants and settingTwenty-two journalists (mainly specialising in health reporting, average 14.5 years’ experience) based in Australia.ResultsThis sample of journalists acknowledged the potential harms of medical tests but felt that knowledge of harms was low among journalists and the public at large. Most were aware of the term overdiagnosis, but commonly felt that it is challenging to both understand and communicate in light of strong beliefs in the benefits of early detection. Journalists felt that newsworthiness in the form of major public health impact was the key ingredient for stories about medical tests. The journalists acknowledged that factors, like the press release and ‘click bait culture’ in particular, can influence the framing of coverage about tests. Lack of knowledge and training, as well as time pressures, were perceived to be the main barriers to critical reporting on tests. Journalists felt that training and better access to information about potential harms would enable more critical reporting.ConclusionsEffectively communicating overdiagnosis is a challenge in light of common beliefs about the benefits of testing and the culture of current journalism practices. Providing journalists with training, support and better access to information about potential harms of tests could aid critical reporting of tests.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Journalists’ views on media coverage of medical tests and overdiagnosis: a qualitative study

et al. 2021

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“…Improving the quality of medical reporting is a crucial endeavour given the powerful influence of the media on the public’s perceptions and usage of healthcare 17 37. This study is part of a global effort to offer journalists more training and support on these challenging issues 36 38.…”

Section: Discussionmentioning

confidence: 99%

“…Overdiagnosis occurs when individuals are labelled with a technically correct diagnosis that does not improve health outcomes or causes more harm than benefit,15 and is now recognised as a key challenge to human health and health system sustainability 16. A recent cross-sectional study of global media coverage of over 1000 media stories about five early detection tests (eg, three-dimensional mammography for breast cancer, liquid biopsy for cancer, blood biomarker tests for dementia) found that the potential benefits of testing were presented far more frequently than any potential harms (97% vs 37%, respectively), and the risk of overdiagnosis was only mentioned in 5% of stories 17. The general public and patients already tend to overestimate the benefits of early detection,14 18 meaning that the media’s often unrealistic and overly optimistic portrayals19 can reinforce these perceptions.…”

Section: Introductionmentioning

confidence: 99%

“… 16 A recent cross-sectional study of global media coverage of over 1000 media stories about five early detection tests (eg, three-dimensional mammography for breast cancer, liquid biopsy for cancer, blood biomarker tests for dementia) found that the potential benefits of testing were presented far more frequently than any potential harms (97% vs 37%, respectively), and the risk of overdiagnosis was only mentioned in 5% of stories. 17 The general public and patients already tend to overestimate the benefits of early detection, 14 18 meaning that the media’s often unrealistic and overly optimistic portrayals 19 can reinforce these perceptions. Research has also found media coverage can influence patterns of healthcare utilisation, with positive coverage of a test or treatment associated with increases in utilisation.…”

Section: Introductionmentioning

confidence: 99%

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Interventions to improve media coverage of medical research: a codesigned feasibility and acceptability study with Australian journalists

et al. 2022

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ObjectivesAlthough the media can influence public perceptions and utilisation of healthcare, journalists generally receive no routine training in interpreting and reporting on medical research. Given growing evidence about the problems of medical overuse, the need for quality media reporting has become a greater priority. This study aimed to codesign and assess the feasibility of a multicomponent training intervention for journalists in Australia.DesignA small pragmatic feasibility study using a pre- and postdesign.Setting90 min online workshop.ParticipantsEight journalists currently working in Australia, recruited through the study’s journalist advisor and existing contacts of the researchers.InterventionThe training intervention covered a range of topics, including study designs, conflicts of interest, misleading medical statistics, population screening and overdiagnosis. The intervention also provided tools to help journalists with reporting, including a Tip Sheet and list of expert contacts in health and medicine. Preworkshop and postworkshop questionnaires were administered via Qualtrics.MeasuresAcceptability and feasibility of the intervention, and journalists’ knowledge of overdiagnosis and common issues with health stories. Quantitative results were analysed descriptively using SPSS. Qualitative data were thematically analysed.ResultsAll participants completed preworkshop and postworkshop questionnaires, and 6 completed the 6-week follow-up (75% retention). Feasibility findings suggest the intervention is acceptable and relevant to journalists, with participants indicating the workshop increased confidence with reporting on medical research. We observed increases in knowledge preworkshop to postworkshop for all knowledge measures on overdiagnosis and common issues with media coverage of medicine. Analysis of free-text responses identified several areas for improvement, such as including more examples to aid understanding of the counterintuitive topic of overdiagnosis and more time for discussion.ConclusionsPiloting suggested the multicomponent training intervention is acceptable to journalists and provided important feedback and insights to inform a future trial of the intervention’s impact on media coverage of medicine.

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Advertising or Evidence?—Why We Need System Changes in Academia to Improve Media Reporting

McCartney

2021

JAMA Intern Med

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Limitations include use of a measure of EHR work that considers only when clinicians are actively working (thus likely underestimating total time spent on the EHR), a focus on ambulatory practices, an inability to describe the breakdown of after-hours activity, and lack of accounting for time spent by scribes on documentation.The interspecialty differences we have identified are important given the known associations between administrative burden and clinician burnout. Further investigation should seek to characterize the reasons underlying these differences and identify interventions that reduce the EHR burden.

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Global Media Coverage of the Benefits and Harms of Early Detection Tests

Cited by 16 publications

References 6 publications

Journalists’ views on media coverage of medical tests and overdiagnosis: a qualitative study

Journalists’ views on media coverage of medical tests and overdiagnosis: a qualitative study

Interventions to improve media coverage of medical research: a codesigned feasibility and acceptability study with Australian journalists

Advertising or Evidence?—Why We Need System Changes in Academia to Improve Media Reporting

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