Medical journalist Julia Belluz was invited to give a talk on evidence-based medical journalism and has shared the gist of it with us as a Vox post. She includes a brief history of the development of evidence-based medicine beginning a couple of decades ago, explains how the idea has spilled over (to some extent) to us journalists, diagnoses what’s wrong with medical journalism, and suggests some fixes. A lot of this applies to nonmedical science journalism–and for that matter all kinds of science and medical writing (and editing) as well.
Her Number 1 pick among the barriers to good journalism is lack of access to paywalled papers. Maybe this is only the perspective of someone who was doing medical journalism long before email and PubMed, but access today is heavenly compared to the Way It Used to Be.
- Used to be you’d need to travel to a medical library, which meant a big city (and permission to enter the sacred precincts, not always easy to arrange.)
- Used to be you’d have to pore through the huge bound volumes of the Index Medicus and its columns of .5 point type. (OK, I exaggerate. It was probably at least 3 point type.)
- Used to be the journal(s) you needed might or might not be available–but in any case you would have to fill out and turn in separate request slips for each paper and wait half an hour or more to learn whether you could get it.
At least there were photocopiers. Not free, of course. I used a lot of index cards.
Today, everything is online. Everything. Today there are many open-access journals. Today even the paywalled ones often make older papers available free. Today you can sometimes get a full text paper just by Googling its exact title (leave the period off.)
Most of all, today there is PubMed, the matchless gift of the American taxpayer. A national treasure:
- Really really good Boolean Search, by topic, keyword, author, etc. etc..
- Abstracts of everything that has an abstract, even paywalled papers.
- Links to full text when available, and an increasing proportion of papers are, even many papers that are paywalled at the journal site.
- Information about corresponding authors, with email addresses, so you can write and ask for a copy. An amazing percentage of these will come to you quickly, and you’ll get nearly all before long.
- Searchable full-text of hundreds (thousands?) of medical books, a rich resource for some reason not well known.
- Lots of other resources, some of which even I haven’t investigated yet.
Also, journalists with a few recent clips to show can usually sign up with various journals to get advance notice of upcoming papers and access to previously published ones. Or via Eurekalert.
Also, membership in professional organizations can smooth your way. I’m a longtime member of two that have been valuable for many reasons, including entrée: the National Association of Science Writers (where I was a Board member for many years) and the Association of Health Care Journalists.
HYPE, CLICKBAIT, AND OTHER ILLS
Belluz lists four of the five other challenges she sees to excellence in medical journalism as separate items. I tend to lump them together under the heading Media Evils Today. Collectively they amount to overstating or otherwise mis-stating a finding to make it seem more significant or compelling than it is. Some examples: Assuming that an animal study is directly relevant to people or that that a study with a small number of subjects has population-wide implications.
One of these issues is hype emanating from the science itself, often embodied in misleading press releases. Sometimes this can be blamed on publicity-seeking efforts by the scientists or the institutions where they work. But it’s a crucial source of misinformation because so many media outlets rely heavily on press releases or even publish them word-for-word, presenting them as news stories. So hurray for HealthNewsReview, which has recently started reviewing and rating press releases in addition to its original focus, news stories. This is the only effort I know of that is working to keep institutions honest in explaining the science they do.
The other three issues are problems faced by journalists themselves. One is lack of time to investigate the background and complexities of a piece of research so as to set it into context. Another is pressure to produce news daily or even oftener. The third, most worrisome, is pressure to produce news that will attract eyeballs and mouse clicks. That leads, inevitably, to hype.
Belluz says, correctly, that today’s media formats present opportunities for excellence too. We have fewer space constraints than dead-tree journalism, so we can explain more. We can update with ease. We can link to background information, primary studies, and other kinds of illumination.
Arrayed against those, however, are those clickbait pressures. The desire for short uncomplicated-but-startling pieces for readers with short attention spans. Reduced use of links that might take eyeballs away from the site. I don’t know how to fix these things. Suggestions welcome.
Belluz has a few proposed solutions. She wants researchers “to reach out to reporters at news outlets on the other side of the political divide, who may not share their views.” Lots of luck with that.
She also wants them to hold media to account. There’s a fair amount of that already among scientist-bloggers–Steven Novella at NeuroLogica, the Eisen twins Michael, at It Is NOT Junk and Jonathan, at the Tree of Life, plus a number of others–although we could always use more. I was astonished at the roar that attended Siddhartha Mukherjee’s New Yorker piece on epigenetics, which I discussed here at On Science Blogs.
Belluz wants more tools for journalists to be able to “quickly make sense of science.” She mentions in particular the valuable Cochrane Reviews. Yes, of course we could always use more, but there are more:
- AHCJ regularly publishes guides like its Orlando-shooting related list of data resources on firearms.
- NASW publishes a daily link to a resource on science and medical writing, which you can access from the home page.
- I have already mentioned HealthNewsReview, but here’s the home page.
- The Open Notebook analyzes many examples of fine science storytelling.
- The New England Journal of Medicine’s daily newsletter JWatch, aimed at medical professionals, summarizes new findings briefly, often with short commentaries that set them in context. Only some content is free.
- The recently expanded Retraction Watch will keep you in daily touch with what’s dubious in science and medicine.
- Paul Raeburn has revived the much-mourned Knight Science Journalism Tracker at Undark, but it’s no longer daily. More important, it’s very hard to find at Undark’s frustrating Search. Which is opaque, the very opposite of undark.
- An especially remarkable new publication is STAT, most valuable for its persistently clear-eyed assessment of what’s new and not so new in medicine and the medical industry. It also, not coincidentally, publishes several of the finest medical and science writers working today.
- Vox, of course. Consistently reliable, slightly snarky, specializes in explainers.
- Oh, and I almost forgot. I do regular critiques of science and medical writing here at On Science Blogs.
Inevitably, I’ve left out other excellent resources. Apologies in advance, and please remind me. I’ll be happy to augment this list.