SINGAPORE: Before a Select Committee that probes into deliberate online falsehoods and guidelines to safeguard against them are in place, there are ways consumers can be more selective of the health information they encounter online.
Googling health topics can elicit conflicting information - sometimes from credible sources, no less - that it can be baffling trying to make sense of health news.
Take the MMR (mumps, measles, rubella) vaccine, for example. In 1998, Lancet, the reputable medical journal, published British researcher Andrew Wakefield's study that linked the vaccine to autism.
Wakefield was subsequently discredited and barred from practising medicine after numerous major studies found no evidence of a link.
How, then, do you decipher what's worth believing?
STEMMING FAKE NEWS
There are medical professionals who operate websites that report cases of fake health news. For example, David Colquhoun, a professor of pharmacology at University College London, has been running the website DC's Improbable Science since 2003 to expose pseudoscience, particularly alternative medicine.
Examples cited include instances where misinformation has led to unfortunate patient fatalities.
Joining the bandwagon are governmental agencies that are leading the charge against fake news. For example, Thailand's Ministry of Health recently launched the smartphone app Media Watch in November 2017 to enable citizens to report controversial media they encounter on the internet.
In Taiwan, the government is introducing a new curriculum, Media Literacy, in school to teach children how to identify and combat fake news.
DECIPHERING FOR YOURSELF
How do you discern for yourself if the article you've read is fact or fiction? Who should you believe when there is contradicting information?
The International Federation of Library Associations and Institutions (IFLA) recommends these eight steps to verify a piece of news:
- Consider the source to understand its mission.
- Read beyond the headline, which is often sensational and attention-grabbing.
- Check the authors to see if they are real and credible.
- Assess the supporting sources to ensure they support the story.
- Check the date of publication to see if the story is up to date and relevant.
- Ask if it is a joke. If it is too outlandish, it might be satire.
- Check your own biases to see if your beliefs may affect your judgement.
- Ask experts or search through a fact-checking site.
When reading a medical research publication, pay attention to these components of the research:
This is the formulation of trials and experiments, and provides the details of how the research was conducted.
A clinical study can be a treatment study (randomised or non-randomised control trial) or observational study (for example, case report, case series, population study, cohort study, case-control study, cross-sectional study).
Randomised controlled double-blind trials provide the most useful information but sometimes, it is not possible to do such trials for ethical reasons. The next best type of study is the cohort study, in which researchers compare two groups of people over a period of time.
Whatever the study design, remember that each study is subject to different types of bias. For example, if a study to ascertain the link between breast cancer and hormone replacement therapy (HRT) involves the researcher interviewing the subjects, it may be exposed to interviewer bias.
The interviewer may be more inquisitive and phrase his questions differently to subjects with breast cancer, thus making the ascertainment of exposure more likely in diseased than non-diseased individuals.
SUBJECTS OF THE STUDY
Note the number of people or animals included in the research. In general, the more subjects that are studied, the better the chance that any phenomenon observed in the study is real, and not a result of chance or coincidence.
For example, the results of a study that involve thousands of people would be more plausible and credible compared with that of a study with 20 patients.
The type of subjects is also important. Check if the researchers worked with humans, animals, cultured cells, or molecules. If a study is not done on people, the results of the study may or may not be relevant to humans. For example, a drug that works for a mouse may not work in humans.
STATISTICS USED IN THE STUDY
Be cautious when reading the interpretations of a study. A common cause for confusion lies between the terms "absolute risk" and "relative risk".
Absolute risk of a disease is the risk of a person developing the disease over a time period. Relative risk is used to compare the risk in two different groups of people.
Many reports on the benefits of a treatment present risk results as relative risk reduction rather than absolute risk reduction. This often makes the treatment seem better than they actually are.
For example, a new drug was tested in a population with a heart attack risk of 2 per cent. It reduced the risk to 1 per cent, hence the absolute risk reduction is only 1 per cent. However, the drug company would publish its data as risk reduction by 50 per cent (relative risk).
FUNDING OF THE STUDY
A majority of medical studies are funded by government agencies or pharmaceutical companies. Although there is a general perception that industry-based funding could potentially skew the results in favour of a drug or device, it does not necessarily mean that the results of any pharmaceutical company sponsored research is biased.
However, you should always consider the funding source and potential financial interests of the authors or researchers when evaluating the results and conclusions of a research study.
Check that the journal in which the study was published in is a peer-reviewed publication. Peer review is the evaluation of the work by a one or more people with some competence in the field of research, and this constitutes a form of self-regulation and ensures standards of quality, hence providing credibility.
If you are still unsure whether the health news you are reading is fake or otherwise, consult your doctor. He would usually provide an unbiased source of opinion, as he has nothing to gain from hiding the truth from you.
Edwin Chng is the deputy medical director of Parkway Shenton.