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Health Issues in the Headlines: Learning to Read Between the Lines

Health Issues in the Headlines: Learning to Read Between the Lines

– [Elizabeth] Just a little slow? All right, well let’s go
ahead and get started. Welcome everyone, to
Health in the Headlines, quick little evaluation to
combat fake news in the media. We’re gonna go over just a
little bit of housekeeping in advance, this gives
some other folks time to join us on the line, and
for you to get a little bit more comfortable with
the video conferencing software that we’re using. So we’re using Zoom technology here, all participants, as they join, are gonna be automatically muted. We really do this to cut
down background noise. We’ve all been in that situation before, where you’re eating Pringles at your desk, you’re settled in for the webinar, and here you are,
broadcast on the recording, so you are muted. We will stop several times
throughout the presentation and check for questions, so if you do have a question
during the presentation, just go ahead and put it
in the chat box for us, we’ll see that come in and we
will read it out for everyone, so that we can all benefit. So, recording, just a heads-up, that we do record our webinars. We record these so that we can make them available to other members, who can access them on
our YouTube channel. So, just putting in a plug
for our YouTube channel. If you haven’t been there before, we have a wide range of webinars, and other presentations available to you, surrounding the issue of health
information for the topic. For those of you who are
new to an NNLM webinar, just a heads-up, the National Network of Libraries of Medicine
is a program of the National Libraries of Medicine, – [Bobbi] Listen, I’m
getting new comments, our sound is going in and out. – [Elizabeth] Oh, is that so? Let’s see if we can’t just
bring this a little bit closer. – [Bobbi] Let me make sure
that’s the sound source. – [Elizabeth] Ah, you want that on? This one? – [Bobbi] Yeah. – [Elizabeth] All right! Oh, I’m so glad someone said something. – [Bobbi] Okay, can you guys
hear us now, in the chat? I see a couple people, better,
yes, alright, excellent. Thank you so much for letting us know before we got too far in. – [Elizabeth] Ah, thank you so much. We just got a new microphone here in our room, and we’re still adjusting to it, but the sound quality
should be a lot better than the one that we’ve used previously. So, excellent. Where was I? The program. So the National Network of
Libraries of Medicine Program has been around for over 50 years. What this program does
is outreach and education on behalf of the National
Library of Medicine. And a big part of that education is conducted through webinars like this, on various health information topics. We do promote NLM resources and tools, and you’ll see some of those
in this webinar as well. So let’s go ahead and
just introduce ourselves. – [Bobbi] Well, let’s see if we can get, there we go. Alright, so I am Bobbi Newman, and I am the Community Engagement
and Outreach Specialist, here at the National Network
of Libraries of Medicine, Greater Midwest Region, which is all a very fancy way of saying I kinda put the public
libraries in our 10-state area. You can see the 10 states on
the wall of the map behind us. From North and South Dakota,
all the way over to Kentucky. Yeah, Liz? – [Elizabeth] My name is Liz Kiscaden, I am also here with the
Greater Midwest Region office, of the National Network
of Libraries of Medicine. And we’re located at
the University of Iowa, in Iowa City, Iowa, which is a lot of Iowa. If you’re ever in the area, feel free to stop by and visit us, we’re located in Hardin Library for the Health Sciences, on the second floor here. – [Bobbi] Alright, we’re
gonna go ahead and go. I am gonna stop our
video, so that we won’t be distracting you or ourselves. But you should be able
to see the PowerPoint. Alright, today we’re gonna talk about Health in the Headlines,
so let’s get to it. We’re gonna be introducing you guys to some health news
sources, and then talk about what happens between maybe some of the research
that’s being done, and the time you see a headline. Highlighting that health,
and how it ends up that way. A little bit about assessing health information in the media, and then share some reliable
sources of health information. So, this is a pop quiz for you guys. Go ahead and type in the chat box, maybe. Where do you get your news sources? Or where do you get your health news? And/or where do you think your patrons are getting their health news? And it’s okay to confess
that you get it on Facebook. – [Elizabeth] No judgment here. Just put it out there. – [Bobbi] See where
you guys get your news. – [Elizabeth] And you can go ahead and just put this
information in the chat box, and we’ll read a few of these out, just to kinda give our
attendees a sense of– – [Bobbi] Somebody said celebrity doctors. – [Elizabeth] Alright! (laughs) – [Bobbi] CNN, Twitter, Wall
Street Journal, JMA, JAMA, Dr. Oz, oh, I hope those
are for your patrons. The Cleveland Clinic,
Mayo Clinic, blogs, Vox, Oh, somebody says that
they go to MedlinePlus after seeing something on Facebook. – [Elizabeth] Oh my
goodness, that’s fantastic. – [Bobbi] You get a prize. – [Elizabeth] For those
of you not familiar, MedlinePlus is a consumer health resource, that’s created and maintained by the National Library of Medicine. We’ll be sharing a few
resources from that later on. – [Bobbi] Oh, and WebMD, is, I guess, the other one in there. And some good people said
CDC and FDA email alerts. Okay, good, there’s such a
great blend of stuff in there. It’s nice to see you guys are taking advantage of all of your options. So, I’m sure you guys have all seen this health headline making the rounds. I have to say, I get
really excited about this, because I will confess,
I am not a gym person. – [Elizabeth] Me either. – [Bobbi] I go, but,
boy, it is a struggle. So I would be much happier
if I could just drink half a bottle of wine and call
that three hours at the gym. (laughs) – [Elizabeth] I want to support this. – [Bobbi] But, this is just
an example of one of the health headlines you
might be seeing around this time of year. And, of course if red
wine is good for you, why wouldn’t vodka be better? – [Elizabeth] It stands to reason. – [Bobbi] Right? Yes. It’s clear, I don’t know. (laughs) So, let’s take a little bit
of a look at some of these. This one, I think, was
making the rounds last year, and I think I’ve seen things similar to this already this year. And this is a great article, well, great example,
maybe not a great article. Talking about some of the
health headlines we see. And in this case, this actually ends up being a good example for one reason, and that is because they
actually link to their source. And Liz will talk a little
bit more about this later. – [Elizabeth] Look at that.
– [Bobbi] Yeah, I know. A lot of times they’re just
referring to like a study, and don’t link out to anywhere. So, I clicked on the link to the study, and I found some interesting information. And I’ve got some really
bad news for you guys. Actually what they found is that, when you eat plants, there’s
a microbial product produced that is beneficial during influenza. And the best way to intake
the number of plants you need, or these
flavonoids that you need, is eating fruits and vegetables. It’s not tea or wine. – [Elizabeth] Oh, that is disappointing. – [Bobbi] And in fact, it’s
still the recommended that one glass of wine, and
that, oh you can’t see me, but it’s really that five ounces. – [Elizabeth] (laughs) Not a fishbowl. – [Bobbi] It’s not a fishbowl, it’s not that glass you pour
the whole bottle into. (laughs) So, yeah, that’s the bad news. And here is just some more
examples, I think, of, (laughs) we’ve got some people
in the chat who are sad too. (both instructors laugh) – [Elizabeth] We’ve got good company. – [Bobbi] These are just
some other examples of maybe health headlines
that we see going around, on social media or other places, maybe your aunt or uncle who’s still forwarding those emails to you, are sending some of these your way. And we’ll get more into
these, this fart thing, with the cancer later. (laughs) So, let’s talk a bit about some of the popular news sources for health news. Oh, wait, okay. Something is wrong with the… – [Elizabeth] Don’t panic, it’s good. – [Bobbi] With the way that this has been, but the display is working. So, one of the things that they give out, is if you’re getting your
news from social media is, that beware of letting
commercial algorithms decide what news you get to see. So, sorry, that’s you
Facebook and Twitter users, and maybe some of the other
apps out there as well. According to a 2016 study
by the Pew Research Center, six in 10 Americans get
their news from social media, and Facebook is still the
most popular source for that. So, you can kinda see
here, what’s coming up. And then, Liz wanted to make (laughs) make a little plug from our,
the GMR Facebook page, here, so you can choose to get your
health news from the GMR page. But I just wanna remind everybody, that Facebook has been
working on their algorithms, but I still don’t think that those are something that you
should be relying on to predict the best information. – [Elizabeth] I’d also
say, depending on the size of the news outlet,
they may or may not have scientific journalists on their staff. So, in some cases, larger news outlets might have journalists that are trained to interpret scientific research, and make it easily understandable
and report to the public, and sometimes they don’t. So just be aware of that. I know we included some
examples in the images here, of things like large media agencies, Washington Post, for example, does employ science journalists, as well as magazines,
more commercial outlets, O Magazine, Cosmo, Glamour, I’ve seen some strange things
come out of those titles. TV and local newspapers
oftentimes get their information from major news wires,
like Associated Press, and United Press International, which in turn, often source their information from press releases, and we’ll talk a little
bit about that as well. But for those of us who
rely on some local news, or smaller newspapers,
oftentimes, they’re not working with a specialized
journalist on their team. And we’ll talk a little bit about challenges for journalists
in our presentation today. – [Bobbi] Yeah, I think I saw
a statistic about the average length of a health news
on a local morning show, being somewhere less,
around 30 seconds, so. – [Elizabeth] Just a little news byte. – [Bobbi] Yeah, just a
little headline clip for ya. Okay, so let’s talk a little bit about some of those challenges
that journalists face when they’re trying to
bring you health news. One of the first ones is that often, journalists don’t have a background in the science that they’re
trying to explain to us. So, you know that there have
been changes to journalism across the country, and often cases, those are cutbacks and that kind of thing. And so, many organizations
that maybe once did employ journalists with a scientific background no longer do so, and
they’re left struggling to make sense of some of the information that’s shared out to them. They’re dealing with
powerful vested interests. They’ve sort of taken on this role of trying to explain science
to the average person, one that maybe they’re not prepared to do, or maybe shouldn’t be doing. They also only have so
much time in the day, just like the rest of us. So, they have to deal with the, oops, let’s probably
head for the next one. They’re probably relying on reporting from scientists or public
relations, press releases. And so, instead of taking
the time it would take to delve down into the research, or read the actual article, they just read the press
release that was sent out, and trust, in some cases maybe rightly so, that it was accurate. And, they’re encouraged by media outlets and other stories, just to repeat stories that
other organizations have shown, especially things related
to health technology, so, in fact, meeting the,
indicates that positive results can sometimes be, they can
be required to share those, or feel pressure to share them. And then of course, in the clickbait era, just getting readers’
attention and having something that grabs readers into the
site, and click on the article, and to spend their precious
time on their media source, is a real pressure. This was a really interesting example of sort of the flip side of that. So, I talked a little
bit about journalists just taking what
scientists say for granted, without challenging it,
and this is an article, if you Google it, it was in… The Post? – [Elizabeth] Yep, it was in the Post. – [Bobbi] The Washington Post. Where, a science writer, so
someone with a background in the information to
understand what she was reading, and what she’d been seeing, wrote a response, or an
assessment to some information that Dean Ornish had shared. And for those of you
who aren’t familiar with his recommendations, Liz,
correct me if I’m wrong here, – [Elizabeth] Oh, yeah,
I’m a Dean Ornish fan, so Dean Ornish does promote a very plant-based diet for folks with cardiovascular
disease or high cholesterol. So I’ll share that high
cholesterol runs in my family, I have the Dean Ornish cookbook, and I’ve been using a lot of these recipes for creating plant-based
meals over the past few years. Sometimes better than others. Comes and goes. – [Bobbi] He definitely has a bad fats, and wants some restrictions for meat, especially I think red meat. And what was really
interesting to me about this, is so, the article published, the author published this article, saying that everything he
says about it is wrong, and he read it and responded, and then she responded again. So this is a conversation
we don’t usually see in science writing, or in reporting. And what was really interesting for me, reading through this, is that they, you got to see how two
people with expertise interpreted the same data. So they both were talking about a report in their responses, that talked about the increase in the amount
of protein and bad fats, and other things that
Americans have been eating, and then both of them
sort of interpreted that information differently,
so this was sort of a good example of people
who know more than me, reading the same information, and coming to a different conclusion. Fascinating. Here’s a nice little comic,
that we thought we’d share, about how science gets
translated into the news cycle. So you can start here at the top, you can see the little bit of a research, is translated by the
Public Relations office, yes, most places have one, and then that is released out to the news wire organizations, and it’s usually, at that
point, simplified down to, as you can see, A causes
B, says scientist. Or, that a news study, which is what we often hear these days, right? Gets out onto the internets, and then eventually, maybe
cable news picks it up, and then your local news source. And then your grandma. (laughs) – [Elizabeth] This is, I like this, it’s timely around the holidays. I don’t know about everyone else, but we had some family
gatherings around Thanksgiving, and I heard a lot of
really interesting reports from health studies
from my family members. But, as you can see from
this comic or illustration, essentially, it’s just the old-fashioned game of telephone, right? By the time we hear that news information, it is so far disconnected
from the actual research that was developed at the beginning. – [Bobbi] This is one of my
favorite things to talk about. How many of you are familiar
with this chocolate article, and this, I guess case
study I wanna talk about? Well not really, but yeah. – [Elizabeth] Yeah, it’s a case study. – [Bobbi] So, I’ve got some
really bad news for you guys. If you’ve seen the
information out there about how good science, or
chocolate is for your health, there is a study that was conducted, wait, it’s not even a study. Let me back up. A journalist (laughs) set up
a low-quality health study. What he did was take a
small group of people, I think only about 16,
and then he tested them for a huge pool of different things. And so, not to go too far into depth, but when you do research like that, you’re very lucky to find one thing to be statistically significant. So the outcome of what he was doing was that chocolate was
helpful for weight loss. But he could have just as
easily found something else. Like drinking coffee, or I’m not sure all the variables he controlled for, but– – [Elizabeth] I think
chocolate’s a good choice, that’s something I wanna believe. – [Bobbi] Right, people
wanna believe that, and that’s important too. So, what he did was conduct a bad study, and then he published, he
wrote an article about it, and then he submitted
it to some, let’s say, questionable news sources or journals, so probably predatory journals, where he paid to have
his research published, and then he wrote a really
nice press release about it. And sent that out to news sources, like we saw in the last little cycle. And this was something that, basically, news sources picked up
quickly, and was quickly spread through the outlets, including Modern Healthcare, Huffington
Post, Cosmo, et cetera. But it’s a great example of how easy it is to conduct a bad study, and how interested people are in reporting that study. And his whole intent really was to prove how easy this was to be done. – [Elizabeth] Exactly, yeah. This actually really
went viral at the time. It was picked up internationally, in fact. I heard a little clip
about this on the radio on a health information
piece done by John Tesh, which some of you may be familiar with. It’s kind of a celebrity information guru. So, at the time, this
was all over the place. And again, it’s something I
certainly want to believe. It’s a title that is sensational, right? It’s shocking, exciting for
those of us that like chocolate, and surprisingly easy to get out there. – [Bobbi] Yeah, it really was. Oops, I didn’t, I missed,
there was bullets. Does this change the practice, no. (Liz laughs) Alright, so let’s talk a little bit about how people search for
health information online. We know that eight in 10
Americans, or U.S. adults, have sought information online, and start their search inquiry at a search engine like
Bing or Yahoo or Google. And half of those searches are performed on behalf of someone else. So, whether they’re interested, they’re a caregiver, or
looking for health information about someone in their life, and then, a little less than
five percent of the searches actually go ahead and, a lot of them come up against a pay wall, but some of them then go ahead and pay for the information
behind that pay wall. So, that’s why having good
sources, like MH, matter. And the other thing that was
really interesting about this is that a good 20 to 30%
of information seekers actually read about the
experience of others online. So, in this case, they’re reading about people sharing their experiences, whatever type of website it is, and using that information
to make health decisions. – [Elizabeth] And for those of
you interested in this study, that came up Pew, it’s
actually incredibly good, it’s called the Diagnosis Difference. You can search for that
online and get a whole bunch of information from there about searching health information online. – [Bobbi] And, of
course, we read the news. This is another study,
this was undertaken by the AP-NORC, Center for Public Health Affairs Research. Essentially that basically, most Americans report that they just read the headlines. Only 41% of Americans
report that they actually go beyond the headlines,
or last longer than that sound clip at the top of the hour, to find out what the real news story is. I thought there was a message,
let’s see if this slide, I can’t remember what it was. – [Elizabeth] Well, I’ll just say that that’s my practice as well. I’m embarrassed to say that, oftentimes, when I read something in the headlines, I don’t read beyond it and then I continue to tell people at my local bus stop about surprising new
studies that have come out. So, I’d like to share a
little bit of information about what happens, how do
things get lost in translation from scientific language,
to popular media. Many of you hear buzzwords, I think, related to health reporting, for example, remedy, impact, all-natural, where do some of these terms come from, and how are they translated
from the original study? Alright, I have another cartoon for you. Why do we hear such conflicting reports from scientists, right? This is a cartoon by Jim Borgman, and of course, it’s just
kind of random, right? Smoking can cause heart disease,
in rats, women, you choose. I think one of the
biggest challenges we have is that media commonly reports research from preliminary studies. You’ll often hear the tagline, a new study shows, in common health reporting. So just a little bit of information about what a preliminary study is, reporting from single preliminary studies is actually a problem. A preliminary study is often exploratory. So, it’s often conducted to test the feasibility and the cost of the study, prior to conducting a larger one. So for example, instead of
recruiting hundreds of adults, with a specific condition,
hey let’s see what we can do with a handful of graduate
students on campus, and see if we can create
something that may be feasible at a larger level. So they tend to be small. And often they tend to be animal studies. And when we get to our piece on evaluating health information, that’s one of those
important things to look for. Was this a study done on animals alone? With rats for example? Or was it done on human beings? And who were those human beings? What we often don’t hear about is the next part of the
process that should follow. Which is the replication of that study, to determine if the results are valid. Another term for this is reproducibility. That replication, or reproducibility, is particularly important for sensational findings
with large implications. For example, the chocolate study that Bobbi had showed previously. Another famous example of
that is of Andrew Wakefield, whose 1998 publication in the Lancet claimed a link between autism and the MMR, or measles, mumps, and rubella
vaccination in children. A decade following that study, none of the other research
teams were able to replicate it. But it’s already been in
the public consciousness. As an American astronomer claimed, extraordinary claims should be backed by extraordinary evidence. So when you see something like this, that is a preliminary study,
reported in the media, think about how reproducible that is and whether those findings
can be generalized. Another element that plays
into this is publication bias. Scholarly journals themselves have a bias towards publishing new,
groundbreaking studies. So again, it’s that
element of sensationalism. There is very little
interest in publishing studies which results are inconclusive, or that lacks evidence. There is also not a lot
of interest in publishing a lot of replication studies, which is why we see a
lot of these smaller, preliminary studies being reported. Researchers at our universities, just like the University of
Iowa, where we’re home to, are always under pressure to publish. Promotions and tenure
are increasingly tied to bibliometrics, or the
number of publications that they have produced,
and how many times those publications have
been cited by others. Due to this pressure to publish, they focus on what is new or surprising, because that is what’s being
published in the journals. Add to this the fact that
our media also likes to cover unusual, funny, and controversial stories, it kind of increases that broadcast. And I wanna just illustrate
this with another case study. So, this is the one related to farts. And we had this on a earlier slide. I think this is just a nice example of sensationalized reporting
involving a preliminary study. And also of that telephone game effect that we presented earlier. So, dozens of news outlets
released this story. It was all over the place. Yet, the scientists involved in the study never made this claim. So where did it come from? So let’s track back and
see where that came from. In fact, there was a press release from the University of Exeter, which is where this
research team was located, and that press release stated that rotten egg gas holds the
key to healthcare therapies. That press release actually misinterpreted a quote from the research
manuscript itself. The researchers that were
working on this study were using a compound that
delivered small amounts of hydrogen sulfide to mitochondria to determine if the stressed cells in this Petri dish stayed alive. Alright, so this is lab
testing, and it’s preliminary. Within the manuscript, they had a quote. They said, “Although hydrogen
sulfide is well-known “as a pungent, foul-smelling
gas in rotten eggs “and flatulence, it is
naturally produced in the body, “and could in fact be a healthcare hero “with significant implications
for future therapies “for a variety of diseases.” So they used this as
flatulence, as farting, as an example of hydrogen sulfide, and it spun out of
control in news outlets. Hopefully not a lot of you were out there sniffing farts for health benefits, because that’s not gonna get you anywhere, except just in some
weird, awkward situations. So, in fact, I will
say, our own university has had some issues with
misinterpreted press releases. Just back in 2016, we
released a press release from the University of
Iowa, about components of some common spices, oregano and thyme, used as a cure for wasting diseases. The release didn’t
include information that this was an as-yet unpublished
study involving mice only, that part of the motivation for getting the press release out included some commercial interests from the lead researcher that
was looking for patents. So this was a situation that we ran into locally here as well. So, outside of just publication bias, and publishing information
on preliminary studies, we do have misinterpretation
of common scientific terms. Terms like theory, significance,
risk, and evidence. I just wanted to touch on
the literal misinterpretation of some scientific terms. What’s funny, is every once in a while, in our presentation room here, the lights go off, and Bobbi or I have to stand up and
dance around a little bit because they are on a timer. So we’re getting our stretch too. So, what about theory? Oftentimes in the general public, we hear the word theory, and we equate it with idea or supposition. It’s used interchangeably. In fact, in the scientific language, a theory means an
explanation for something that evidence, such as facts and data, exist for, or that can be
tested by an experiment that somebody could perform. In many cases, there’s a
quantity of facts available, and a theory is an
interpretation of those facts. An example of this might
be climate change, right? This isn’t just a guess. It’s a theory that’s based
on scientific evidence. The other example I gave is significance. Now, Bobbi mentioned this earlier. Are the findings of a study
statistically significant? Within statistics, there’s a value known as a probability value. A probability value is used to show that a result is unlikely due to random chance alone. So, a finding is statistically significant if there is less than a
five percent probability that that finding resulted from chance. And that is what that p-value is, that you’ll see reported
in some of those studies. Risk is another term that’s
commonly misinterpreted. This image here actually
comes from the New York Times, and it’s part of an advertisement for the Memorial Sloan
Kettering Cancer Center. And obviously, the purpose of this is to motivate people to go in
for colon cancer screenings. But it doesn’t give you enough information to really determine what the risk is. Risk, in a lot of our scientific findings, is actually determined by a calculation. Let’s take something like this. If you saw a billboard,
when you’re driving, that said, cervical cancer
will strike 80,000 Americans, how do you understand from
that, really what your risk is? Well, to determine
that, you’d need to know what the population was at risk. So how many people could possibly get cervical cancer, right? Well, that’s women. We’ve got 300 million Americans, if you assume that half
of those are female, well that’s how you can get that risk, which comes to 0.5%. So always ask, when you’re
looking at a term like risk, out of how many? And finally, evidence. Evidence is an important
term in scientific language. For myself in my day-to-day, I can say, “Oh, I see evidence that my dog ate again, “the cookies that I set out.” In scientific terms, evidence really is data that comes through
numerous, rigorous testing. So it’s empirical data which
supports a scientific theory. I actually saw a really good
clip from a Frontline video, in which Dr. Seth Mnookin explains what he means when he says that there is no scientific evidence for intervention. What he said was, “I’m as
confident as we can humanly be, “I’m as confident as I am that, “if I were to walk off this building, “I would not be able to fly.” So we’re looking at a
pool of strong evidence that comes through rigorous testing. And just a sidebar, I’ve got an image of buttons on this slide here, for a site called AskForEvidence.org. Now, if you’ve never
been onto this website, I encourage you to check it out, it’s actually a public campaign
to encourage the public, like you and me, to find evidence behind news stories and marketing
claims that we see online. So, another topic related to evidence are levels of evidence. So I just wanted to spend a couple minutes introducing this to you as well. The levels of evidence pyramid
you see on the left here, comes from our own library, but you’ll see variations of this available online. Essentially, the intent is to rank the strength of study
results by the type of study. Loosely, if you were to summarize, there are three main
types of research studies. There are observational studies, such as case-controlled studies, these are smaller
studies where individuals with a particular condition are selected for comparison with another group. They tend to be small
because they involve people with serious diseases that can not or should not be replicated in others. An interventional study is something we’re a little bit more familiar with. Interventional studies are often randomized, controlled trials. Many of you are familiar with these, or may have participated in one. So essentially, you have
a group of individuals, which are randomly allocated into either an experimental group, or a control group to test a intervention. Generally, for best practice, folks shouldn’t know whether they are in the control group or the test group. That’s an example of an
interventional study. Now at the very top of this pyramid, you see summaries of best-quality trials. And I’m going to show you a little bit more about how to find some of this. But that top piece is
called systematic reviews. What a systematic review attempts to do is to identify, evaluate, and synthesize all of the evidence, or all of the studies that meets eligibility criteria to answer a given research question. So for example, we’ve been
talking about chocolate, right? Well, I wanna know if chocolate is really, offers me any health benefits. In an ideal case, I’d be
able to find one of these systematic reviews, one of
that type of publication, which will have collected
all of the studies out there on chocolate, and health outcomes, and summarized it for me. And finally, before I pass
it over to Bobbi again, I just wanted to share this list of terms, that comes from Health News Review. Health News Review has a
mission to help the public, again, find evidence about what they learn about in the news, but it also supports journalists who are reporting on health topics. According to the founder, Gary Schwitzer, these are the seven words
that you shouldn’t use when reporting medical news. And for also, on the other end of that, as consumers of news,
these are the seven words that should be red flags,
if you see something about a cure, a miracle, a
breakthrough, promising, language is important. Gary puts these out as a plea for a more disciplined selection of words by healthcare communicators, in a step to improve
everyone’s healthcare. – [Bobbi] Okay, so now
we’ll talk a little bit about how do you assess
the healthcare information, or the health information you come across in the headlines, or
in the media every day. I use a statistic in
one of my other classes, that nine out of 10 Americans can not, don’t have the health
literacy skills they need to process and understand
the health information they come across every day. And that includes news headlines, which is largely what we’re
talking about in this class, but also advertising media,
any of those kind of things. So, it really is kind of
alarming when you think about it. – [Elizabeth] That’s a lot, yeah. – [Bobbi] There’s a lot of
health information out there. And yeah, so okay. So a couple things that you can look at when you’re trying to assess
health news headlines. The first is, can you identify the research behind this study? The example I gave, with
the drinking tea and wine might help with influenza,
did link through to the study. Now, granted, it wasn’t a good example of actually creating a health
headline or a news article, but at least they did
link to their source. I know I’ve seen a lot of articles where it just says a recent study, and this is gonna talk a little bit more about that, a little bit. If the research was done on animals, or not on humans at least, then it can’t be extrapolated to humans. And when we’re talking about that too, also take into consideration what the demographics of
that study looked like. So, how many people were in the study? The bigger the group, the better. That chocolate story I shared
earlier had 16 people in it. So that’s not very many. And if there’s a control group, which is sort of a basic
thing for scientific research, and then what that control
group actually looked like. Was the purpose of the study to assess what the
headline actually claims? So, for example, Liz gave
the sniffing farts story, that was not the purpose of that study. And often, scientific studies are things that are not, aren’t looking
for things that are as flashy as the headlines that we
often associate with them. So, take a good look at what the study was actually trying to prove. And who paid for the study? Who provided funding for the research? And then also take a look at the sources cited in the article. And at least one of them should not be connected to that
research study in any way. So an independent source. Does the reporting talk about the cost associated with the study, or with the treatment that may be recommending? It’s probably free to sniff farts. I hope so. But not to drink wine. The other things to consider, is this story presented
in a bigger context? Does what you’re reading
sound too good to be true? So, like the headlines about
how good chocolate is for you, or how great wine is for you, maybe you should be thinking, “you know, this sounds a
little too good to be true.” It probably is. And the people they, if, if it’s a news source that they’re interviewing other people
to talk about the study, who are they asking to talk about it? Is that person actually
qualified to talk about it? I like to give an example,
when you’re talking about the idea that we
have to present both sides. If you’re running a morning show program on providing nutritional breakfast, you don’t invite someone on who thinks that cake
is a reasonable option. (both instructors laugh) It is a great treat, but that’s
not both sides of the story. Okay, so let’s look at this next one. – [Elizabeth] So I just wanted
to give everyone an example on how you might go about locating the source of that media report. Now there’s a fancy term for this, which is sourcing articles,
so not that fancy, but now you know, and you
can sling that term around. On the left here, I have a
report from a media outlet on grunting and how it is
helpful for some sports. And you’re gonna see
in here, it doesn’t say who the authors were, what the title was, or what the journal that
it was published in. It does tell me that it’s from Texas, and I can see from here that it involves grunting and athletes, right? On the right side of the
screen, you’ll see a screenshot, so what I did is I went out to PubMed, now for those of you
unfamiliar with PubMed, it’s a biomedical index that
is created and maintained by the National Library of Medicine. It’s freely available,
anyone can go onto PubMed.gov and search for content. In here I used some of the key words that I highlighted from the article, I know it’s Texas, grunting, athletes, and I was able to locate
the actual article. Oftentimes, you don’t need to
pull up the full text article to understand some of this, but you can just look at the abstract,
which is the summary that’s available here in this screenshot. And from here, you can find out
a lot of useful information. So for example, I learned
that the sample size for this study was small. The study included only tennis
players, not all athletes, and included an interesting variable, that included the overall noise, including shouted
encouragement from onlookers. So there were quite a few
variables included in this study. I’m not gonna say that it isn’t valid, ’cause I haven’t looked at it in-depth, but there are enough things
here where I have become a little bit more skeptical. – [Bobbi] There might be
a lot more going on there. Okay, so when we’re
talking about assessing health information, we’re going to go to my favorite source, which is MedlinePlus. There’s some great tools built
into MedlinePlus for you. Under health topics, you’ll find Understanding Medical Research. And this asks some of the same questions you saw me talking about, was, did the study involve animals or people, oh, did the study involve people like you, which is something we
didn’t talk about earlier, that you wanna make sure that the demographics of the health data, or the health information
you’re looking at, reflect the group you’re you, or whatever group you’re trying
to look up information on. And there’s a whole history of that in the healthcare profession, that it tends to be certain groups of people in medical research. Evaluating Health Information, I think this is a great resource, both for library staff and
for the public, our patrons. If you’re looking for
information on the web, it’s a great reminder just to
look for some basic things, I think most of us have heard in the past, for example, is there an about page? What does it say? Is it a .gov website? Et cetera, et cetera. And evaluating health information online. This is slightly different because it goes more specifically into the online aspect of
information publications, but obviously, we try
to point people towards a .gov or .edu or .org address. And this is another great option. This is a video tutorial,
and we know that some people prefer to get their information that way, for a variety of reasons. And it’s a video on
understanding medical words, a tutorial from the National
Library of Medicine. Another option I like to suggest is the National Center for Complementary
and Integrative Health. And when I do, ah yes. Somebody has pointed out
that the restrictions on .org and those type of web addresses have changed, and so yeah, .org isn’t
necessarily as reliable as it used to be as an indicator
for reliable information. But it’s one of many. This other resource I like
to point out is from the National Center for Complementary
and Integrative Health. And this asks some of the similar questions that we’ve seen before. But it really is focused on complementary and integrative health, and I know, sometimes, people feel like those options aren’t getting a fair shake when they’re looking at
other health sources. This has some really great checkpoints, like we’ve already seen
with the other ones. Who runs the site or the app? Can you trust them? Does it do what it’s promising? That kind of thing. But one thing that’s really
great about this website is when you look at the A to Z index of
say health information, let’s say you’re gonna go look at, echinacea.
– [Elizabeth] Dandelion. – [Bobbi] Oh, dang it. (both laugh)
– [Elizabeth] Whichever. – [Bobbi] Go to look at echinacea. It will tell you what we actually know, what the research shows about it. And when I demo this in person, one of the things I like to show, is not only does it tell you what we know, which, bad news guys, it doesn’t actually show that it helps you, echinacea, I don’t know about dandelions, I don’t know what that says.
– [Elizabeth] Oh, wow. – [Bobbi] But it also lets you know what happens if you
choose to keep taking it. If there are harmful side effects, which is kind of nice, because I know, sometimes people choose to
keep taking those things. But there’s good resources here for complementary and alternative information. – [Elizabeth] And also too,
one of the things I like about this, is when you
look at those records, when you’re out at that A to
Z list and you’re looking at dandelion, ginkgo, what have you, each records will have a bottom line. And you can see that
on the screenshot here. What’s the bottom line. And the bottom line
summarizes what evidence, again, scientific evidence from rigorous studies has been collected. In some cases, it will say
there is not enough evidence to support using this,
but studies are ongoing, and in some cases there
will be enough evidence. – [Bobbi] This is a little tricky, I think we all we all run into personal
stories around health every day. And I think that sometimes that’s really, even though you know,
maybe what the scientists’ specific evidence is saying, you know that you should be
looking it up on MedlinePlus, that you,
– [Elizabeth] It’s compelling. – [Bobbi] It’s compelling,
yes, to have a heartfelt story with aspects of it that are
pulling on your emotions. So, one thing to keep in
mind when you’re looking at headlines, or even talking
to someone about health news, is to beware personal stories. Especially when you’re
looking at the results, say, of some type of healthcare option, the chances are that you’re only hearing from the people who had positive
outcomes, is pretty real. And there’s not, a lot of
times these don’t include long-term results, it’s
only a short-term response or short-term results that’s
being reported out again. (clears throat) Excuse me. And as Liz mentioned earlier, a huge part of the scientific process is being able to test it out again. Unfortunately, hey, I replicated that test and it was successful isn’t
a very catchy headline, but it is probably one of
the most important things that happens in the process. – [Elizabeth] And this cartoon here is just showing you the bias when it comes to sharing anecdotes. So, essentially, you’re
not hearing, oftentimes, from those who are not around
anymore to share their story. So, I’m gonna share a few
other reliable sources of health information, and tools that you can take with you
following this webinar. Now, one of those things
I shared earlier was the value of systematic reviews, which are results and a publication type that’s ranked very high
in levels of evidence. We used to have a wonderful
resource that we shared as a part of this class,
called PubMed Health. Now, unfortunately PubMed Health was retired at the end of October. So, instead of using that,
I’m going to show you how to locate systematic
reviews within PubMed. I am going to open this up, now let’s all cross our
fingers, there we go. So here you are in PubMed, and again, for those of you who
have never used this before, PubMed is freely available, it’s a National Library
of Medicine resource. I’m gonna just make this a
little bit bigger for myself. Now, one of the topics we talked about earlier was chocolate,
I’m a big fan myself, and I also mentioned that
I have high cholesterol in my family, so let’s
see if we have anything related to chocolate, and
I’ll just put cardiovascular. – [Bobbi] I’m excited.
– [Elizabeth] I am too. (laughs) All right,
hold your breath folks. What this is is just a
basic key word search. Right, I’m looking for any citation that contains these two terms. Now, I’ll share that
PubMed currently has over 28 million citations in the database, these are generally from
biomedical journals. But PubMed does index some
full textbooks as well. Now, here I am, I’m
looking at all the results. And remember, what we’re
looking for are those high level of evidence
lists, systematic reviews. Over here on the left, you’re gonna see an article types column. Now, what you’ll wanna
do is click customize, and you’re gonna see this
full list of article types. Down on this list, it’s alphabetical, you’re gonna see systematic reviews. You can click that box, and select show. Now you may be wondering at
this step, why nothing happened. What we did is actually just added this to the article types column. Now, when we click on it, it’s going to go ahead and summarize, there we go, we’re gonna be looking at
just those systematic review publications, and you’ll
see that there are 26. And look at this first heading, Chocolate consumption and risk
of cardiovascular diseases. So this is a meta-analysis, which is closely related
to a systematic review, in fact they go further
and they actually summarize the statistical data together as well. So perhaps there is hope. I have not looked at this in advance, so, look at, chocolate
consumption may be associated with reduced risk of
cardiovascular disease. So it looks like I need to be
eating about 100 grams a week. I’ll have to take a look at
the next chocolate bar I go to. But this is an easy way to pull those high levels of evidence, those systematic review publication types. Oops, I’m gonna really
just try to close this. There we go. All right, a couple of other
resources I wanted to share. One of these includes a book
that’s freely available, it’s called Know Your Chances. Some of you may be familiar with this, it’s available in print, as well. But you can access the
full text in PubMed, on the online bookshelf. This is a great book, it’s intended to better understand health information by teaching you about the
numbers behind the messages, the medical statistics on
which the claims are based. I like this resource, ’cause it talks a lot about risk and outcome. Within this book, there are risk charts, that are designed to
put your own health risk into perspective with a number
of different conditions. So, my favorite books on this topic help you develop a healthy skepticism, which brings me to my next title, which is Smart Health Choices. This book is intended to
help folks like you and I, and practitioners, to
develop skills to assess health advice, and to make decisions that improve the quality of care. Somewhere in the description of the book, it includes information about dealing with the conflicting flood
of health information that deluges us every
day through the media. And in fact, they have a lot of content about that in this book. This is also freely
available through PubMed, in the online bookshelf, it deals with some of
those scientific concepts we discussed earlier, what is evidence, how do you assess it, what is probability, and how do I see through some
of the noise, some of that sensational news in the headlines. Finally, I wanted to put in a
plug for Health News Review. I mentioned Gary Schwitzer before, he is at the University of Minnesota, and he’s the founder
of Health News Review. This is a fantastic resource. Their mission is to
improve the public dialogue about healthcare by helping the public particularly analyze claims
about healthcare inventions. If you look at their blog
today, you’re gonna see a few new health news stories. They take these health news
stories from the media, and actually critically
analyze them for you. Just this week, there
was one posted called USA Today provides rosy speculation about Alzheimer’s vaccine
not yet tested in humans, and another one, Newsweek
trumpets an aggressive new cancer drug, but where’s the data? So this is a great place to go, to familiarize yourself with the process of critical analysis. They also include some great toolkits, in fact there’s a toolkit for the public, for you and me, to analyze studies. There’s a Podcast series, and I say, the editorial team for
this resource is amazing. They, it includes clinicians,
and scientific columnists at larger media centers
like Washington Post, Gary himself has over 43 years in radio, television, multimedia, and the internet, and in fact he will be
presenting a webinar coming up right next week. So I will be hosting that,
Gary will be our guest, that is scheduled for next week, Thursday, at 1:00 central time. You can go ahead and register that, for that any time, it’s part of our Kernel of Knowledge
expert speakers series. – [Bobbi] Okay Liz, in the chat, somebody is stating that this website will not have daily content
after the end of this year. You wanna address that? – [Elizabeth] Yep, that is correct. So, I did talk to Gary about
this in fact, earlier today. There will be some
limited funding available, so the resource will be maintained. You will not see as many
posts as you have in the past. So, this has been funded
through grants previously, the current grant is gonna be running out at the end of the year here, but it sounds like Gary has
found some limited funding to maintain it on an ongoing basis. So it’s still gonna be out there, you’re just not gonna see
as much activity on it. – [Bobbi] Okay, we’ve got
about five minutes left, so that’s worked out pretty well. So what next? I see some of you in the
chat, are names I recognize, either as colleagues here at NNLM, or people we’ve worked with in the past. But if you’re new to the National Network of Libraries of Medicine, please consider joining the network. I know it says Libraries of Medicine, but the network really is for everyone. It is organizational, not individual. So you wanna see if your library, or your organization is a member. And when you do that,
you can apply for funding for health and wellness
information programs and outreach. And we’ll also provide complimentary print-outs and posters
for your library patrons, such as this lovely one
that we partnered with the American Library Association on, so we partnered with them to make, gosh, now I think there’s 15 maybe, – [Elizabeth] Yeah, there’s a whole bunch of because statements. – [Bobbi] Because statements, with the Libraries Transform campaign, and we have nice 11 by
17 versions of those. – [Elizabeth] Mmhmm, take ’em
home, put ’em in your office, put ’em in your library,
put ’em in your dorm room, – [Bobbi] Hang it in the
back window of your car, – [Elizabeth] Whatever you need to do. (both laugh) You can also keep up with us by following us on Twitter, if you’re a Tweeter, I do my
best to maintain our account. And if you’re a Facebook
user, you can like– – [Bobbi] That’s me. – [Elizabeth] Yeah,
that’s everybody. (laughs) You can follow us on Facebook. We do post health news information there, but also, more educational opportunities. So we have four minutes for questions, if anybody has any questions? – [Bobbi] And I’ll go ahead
and open up our chat box here. Make that a little bit easier. There we go. Somebody has that Because Fake News, yep, there we go.
– [Elizabeth] That’s great! – [Bobbi] Right outside their office. – [Elizabeth] Good for you, Betsy. – [Bobbi] I love that one. – [Elizabeth] Oh, and Heidi
recommended a Podcast, called Two Docs Talk, I’ve never
heard of that before Heidi, and I will follow up and check that out. And Becca, I too am bummed
that Health News Review is gonna be reducing kinda their activity. I know for a while, they
were accepting donations, but I spoke to Gary this morning, and it sounds like he’s
found some funding from the foundation at the University
of Minnesota to sustain it, so they’ve kinda backed away from that. All right, well we, hey, Carolyn, I love Ornish too. I still use my cookbook. – [Bobbi] Oh, thanks, yes. – [Elizabeth] All right, well, Bobbi and I will just hang
around for a few more minutes, but those of you who have places to go, and things to do, go ahead and sign off. We will be putting this recording
up on the YouTube channel, it usually takes us about a week or so, to get everything close captioned, and you’ll see it online then. Thank you all for joining us. – [Announcer] Thanks for watching. This video was produced
by the National Network of Libraries of Medicine. Select the circular channel icon to subscribe to our channel. Select a video thumbnail to watch another video from the channel. (bright music)

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