Saturday 13 November 2010

Reporting that should carry a health warning

On the day the Express was changing its mind - again - about statins, the Mail asked: 'Can taking aspirin in pregnancy make your son infertile?'

As Primly Stable pointed out, this followed previous Mail articles - including one from August - that taking aspirin during pregnancy could 'prevent pre-eclampsia'. But it could also double the risk of miscarriage.

As NHS Behind the Headlines says in response to the 'fertility' story:

Current advice states that pregnant women should avoid ibuprofen and aspirin during pregnancy, although there is no evidence that occasional use of paracetamol is harmful. The results of this study are unlikely to change those recommendations, but women should seek advice from their GP or midwife before taken any medications during their pregnancy.

And they should not seek guidance from stories in the media. Yet articles about miracle cures or health scares have become a staple. Conflicting advice about the dangers or benefits of aspirin, for example, are common, as is poor reporting about medicine, science and research.

Recently, Angry Mob published a post on the 'unacceptable' way a recent study on CPR was reported, particularly by the Mail.

And there are plenty of other examples. Here's another one from the Mail:

How remembering to eat your celery could halt memory loss

A taste for celery is one that many people never acquire, but scientists have just given them a reason to eat it. They have discovered that a chemical found in high concentrations in celery – and in peppers – could halt memory loss as we get older.

The U.S. researchers say the plant compound luteolin reduces inflammation in the brain, which is associated with ageing and its related memory problems, by halting the release of molecules that cause the inflammation.

Only after that does the Mail explain the research was conducted on mice.

NHS Behind the Headlines explains:

Although this is interesting basic research that may give insight into at least one of the processes involved as the brain ages, its direct relevance to humans is limited.

The mice were given a relatively high supplement of pure luteolin. There is not sufficient evidence to suggest that normal dietary consumption of luteolin–rich vegetables such as celery can improve memory in humans.

And:

The Daily Mail’s report has exaggerated the relevance of this study to humans and the effect that eating celery might have on human memory.

Meanwhile, on 13 October, the Express ran the front page headline 'Drug to stop memory loss'.

The paper's health editor, Victoria Fletcher, wrote:

An anti-ageing drug for the brain has come a step closer after an amazing breakthrough by a British team of researchers.

They have discovered that the drug can halt the process that causes frustrating memory problems as we get older.

Early tests suggest the drug can block enzymes that trigger stress hormones linked to ageing.

Once again, it was only several paragraphs into the article that it was revelaed the tests had only been done on mice.

And, once again, NHS Behind the Headlines was not impressed by the way the story has been presented:

This is good research within its own right, and well documented by the researchers in their research paper. However, this is still early-stage research in animals. As there was no long-term follow-up of the animals and its effects on other types of memory, the findings have little immediate relevance to the health of people with dementia. The Daily Express’s front-page report is not justified by this research...

The newspapers have over-interpreted the relevance of these findings to humans.

A few days before that, both the Express and Mail reported on the latest research about the benefits of tea.

Tea, a heart protector: three cups a day can prevent cardiac problems, say experts, claimed the Mail.

Two cups of tea a day 'cuts heart disease' said the more optimistic Express.

But:

The review was reported in both the Daily Mail and Daily Express, whose reporting generally did not reflect the uncertainty of the study’s conclusions. For example, the Mail reported that three cups of tea a day can prevent cardiac problems, while the Express said drinking tea two or three times a day could reduce risk of the disease by 11%. These claims appear to be based on a 2001 analysis, which the reviewers considered to be flawed. The review actually suggests that this earlier research had several problems that undermine the certainty of the results.

Both newspapers also claim that drinking two cups of tea will provide as many antioxidants as eating five portions of vegetables. Although tea does contain antioxidants, the suggestion that it can be a substitute for the numerous health benefits of fruit and vegetables is not supported by this research.

On 18 October, the Express was leading on the 'secret' to a long, healthy life.

And what was this 'secret' that no-one could possibly have ever known about before the Express revealed it on their front page?

...research showed that the answer was a widely varied diet that might include oily fish, porridge oats and blueberries.

Hardly a surprise.

Next they'll be saying that drinking moderately, not smoking, doing exercise, watching your weight and eating less red meat is good for you.

Oh, they already have.

Also in October, the Mail's Fiona MacRae was reporting that 'having a child makes you more intelligent':

New mothers often grumble that their brain has turned into mush. But having a baby may actually make you brighter, a study has found.

Did the study find this? Not exactly:

This story is based on a small study which looked at the brains of 19 new mums, using scans to understand how they changed between two weeks and four months after having a baby. It found that the volume of the certain parts of the brain increased in this period, and that this increase seemed to be greater among women who used more positive words to describe their baby.

Contrary to what is implied by the newspaper, the study did not assess the women’s intelligence, and it is not possible to say whether the changes in brain volume led to any changes in intelligence or behaviour. Also, the study did not examine any women without children, so we cannot say whether the effect only occurs after birth or if it occurs in other situations where new skills must be learnt.

A similar leap was taken by Fiona MacRae in the article 'Violent films, video games and TV shows DO make boys aggressive'.

Watching violent video games, films and TV shows really can make children more aggressive, scientists believe.

DOES this study say that?

The small study looked at brain activity and automatic nervous response (skin sweating) in boys aged 14 to 17 years who were watching short video clips of low-to-moderate levels of aggressive behaviour. The researchers found that sweating and brain response to moderate aggression reduced over time, but response to milder scenes did not change as much. Despite what has been implied by the media, this study did not look at the boys’ behaviour.

Crucially, although this study may suggest some short-term changes in the brain activity of teenage boys watching aggressive material, it cannot tell us if it would actually influence their actions.

Back to the miracle properties of food, and the Express was claiming last week that:

A daily glass of beetroot juice could combat the onset of dementia among older adults.

NHS Behind the Headlines was less convinced:

This news story is a based on a small study in 16 elderly people...conducted over an extremely short time span. Its findings suggest that adults who eat a diet high in nitrates may experience an increased blood flow to certain areas of the brain within a short interval, compared with eating a diet low in nitrates.

However, this does not mean that beetroot juice, or any other food high in nitrates, can help prevent dementia or even improve mental function...

The researchers only measured blood flow in parts of the brain and did not measure the participants’ cognitive abilities. As such, it is not known whether a high nitrate diet does benefit people in this way.

What about the Mail's 'Strict diet two days a week 'cuts risk of breast cancer by 40 per cent'' which was highlighted in Ben Goldacre's recent article about the 'Daily Mail cancer story that torpedoes itself in paragraph 19'?

Well, it appears to have been an accurate cut-and-paste job from a press release, but Cancer Research UK pointed out:

...the way this study has been promoted, and subsequently reported, has been been misleading and inaccurate. In short, this was a study about dieting and weight loss, and not about breast cancer at all. And it can’t be used to conclude anything about breast cancer risk, nor about how women should or shouldn’t diet.

Cancer Research UK have also been at the forefront in challenging claims about cancer being a new, man-made disease.

Andy Coghlan at New Scientist said the:

assertions have dismayed cancer researchers, and have led to a rash of uncritical coverage.

Such as in the Mail, where Fiona MacRae, again, wrote 'Cancer 'is purely man-made' say scientists after finding almost no trace of disease in Egyptian mummies'.

Her article does include several passages very similar to the original press release. For example, press release:

...it was not until the 17th century that they found descriptions of operations for breast and other cancers and the first reports in scientific literature of distinctive tumours have only occurred in the past 200 years, such as scrotal cancer in chimney sweeps in 1775, nasal cancer in snuff users in 1761 and Hodgkin’s disease in 1832.

Mail:

The 17th century provides the first descriptions of operations for breast and other cancers. And the first reports in scientific literature of distinctive tumours only occurred in the past 200 years or so, including scrotal cancer in chimney sweeps in 1775 and nasal cancer in snuff users in 1761.

And, press release:

Evidence of cancer in animal fossils, non-human primates and early humans is scarce – a few dozen, mostly disputed, examples in animal fossils...

Mail:

Fossil evidence of cancer is also sparse, with scientific literature providing a few dozen, mostly disputed, examples in animal fossil...

But Cancer Research say the claims are 'false and misleading':

We were concerned to see headlines in the media today claiming that scientists say cancer is ‘purely man-made’. This is not only scientifically incorrect, but misleading to the public and cancer patients.

Our lifestyles have a great impact on our chances of developing cancer – as we’ve said many times. But the evidence that’s being used to justify these latest headlines doesn’t in any way support the assertion that cancer is modern or man-made.

Coghlan adds:

A quote from [Rosalie] David put out by the University of Manchester saying "There is nothing in the natural environment that can cause cancer. So it has to be a man-made disease, down to pollution and changes to our diet and lifestyle" caused particular consternation.

What's so wrong with that?

There are dozens of natural causes of cancer, including ultraviolet light from the sun, natural radiation from radionuclides such as radon in rocks, and infection by viruses that trigger cancer, such as the human papilloma virus, which causes cervical cancer and hepatitis viruses that can cause liver cancer. Likewise, soot and smoke from fire contain a multitude of carcinogens, as do fungal aflatoxins deposited on peanuts. "And that's to say nothing of cancers caused by genetic inheritance," says Kat Arney of Cancer Research UK.

David then had an opinion piece published in the Mail, which led Cancer Research to rebut the claims again:

Claims that cancer is ‘purely man-made’, based on an interpretation of a relatively small number of ancient remains, are confusing and misleading, and certainly don’t reflect the huge amount of scientific evidence piling up about the true causes of this devastating disease.

Sadly, so much science reporting seems to be 'confusing and misleading' because eye-catching headlines take precedence over accuracy.

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